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Imperial College Healthcare NHS Trust rated as Requires Improvement by CQC

21 February 2018
Imperial College Healthcare NHS Trust
  • Media,
  • Hospitals

A central London NHS trust has been rated Requires Improvement overall by the Care Quality Commission.

Imperial College Healthcare NHS Trust was rated Requires Improvement for being safe, responsive and well-led. It was rated Good for being effective and caring, following the inspection which took place in November and December 2017.

Overall CQC’s rating of the trust has remained the same. The ratings for each of the trust’s acute locations also remained unchanged.

St Mary’s Hospital

Paddington’s St Mary’s Hospital remained at Requires Improvement, although its rating for being well-led has improved. CQC inspected urgent and emergency care during this inspection to check if improvements had been made. The rating for the service stayed the same. It was rated as it as Requires Improvement. Surgery at St Mary’s also remained at Requires Improvement as did Maternity services.

In the outpatients and diagnostic imaging service, inspectors found it hadsignificantly improved and rated it as Good.

Charing Cross Hospital

CQC’s rating of Charing Cross Hospital stayed the same - Requires Improvement. However, the Medical care (including older people’s care) service had improved and is now rated as Good. Urgent and emergency care was given a lower rating of Requires Improvement since CQC’s last inspection. The rating for Outpatients and diagnostic imaging service also improved - to Requires Improvement.

Hammersmith Hospital

At Hammersmith Hospital CQC’s overall rating remained the same at Requires Improvement. There were though some improvements: Surgery had improved to Good as had the Outpatients and diagnostic imaging service. CQC’s rating for medical care (including older people’s care) remained at Requires Improvement.

The ratings tables in our full report show the ratings overall and for each key question, for each service, and for the whole trust. They also show the current ratings for services or parts of them not inspected this time. You can find the ratings table on pages 10 to 14 of the main report attached to this press release.

Inspectors did note some areas of Outstanding practice including:

The trust’s role as a leader in the adoption of digital technologies to improve patient care was recognised in March 2017 when, in partnership with a neighbouring trust, ICHT was selected by NHS England to be one of 16 global digital exemplars in acute care. As a global digital exemplar, the trust receives funding and support to drive forward the use of digital technology and create products and approaches that can be used by other organisations.

In Urgent and emergency care at St Mary’s Hospital

The major trauma centre within the department achieved good outcomes in the Trauma Audit & Research Network (TARN) audit. The trauma department was part of the ‘Redthread’ youth violence intervention programme, which ensured seven-day support from a youth worker embedded in the hospital. Any practitioner could refer a child or young person brought into department where there was a suspicion of violence, assault and/or exploitation.

At Charing Cross Hospital

The Northwest London RAPID (Rapid Access Prostate Imaging and Diagnosis) pathway for prostate cancer streamlined prostate cancer diagnostics. Multiple visits to obtain a diagnosis were reduced to one in which all diagnostic imaging and biopsies were carried out on the same day.

At Hammersmith Hospital

The chest pain pathway provided patients with timely access to cardiac surgery. Cardiac services were being consolidated on the Hammersmith site to provide a specialist cardiac centre.

However, there is action the trust MUST take to improve including:

In Urgent and emergency care:

At St Mary’s Hospital - the trust must ensure that it is monitoring performance effectively against agreed standards. It must also ensure that all portable equipment is regularly serviced and labelled to indicate the next review date.

At Charing Cross Hospital - the trust must ensure that control drugs cupboard key is kept securely and access is appropriately restricted. It must also ensure that there are effective checking systems for airway trolleys and emergency medicines stored in the resuscitation bays.

In Surgery:

At St Mary’s Hospital - the trust must address the low levels of completion of mandatory training amongst medical staff. And the trust must address areas of non-compliance with guidance in relation to the disposal and management of hazardous and clinical waste. The trust must address the poor state of repair of theatres one to seven with urgent consideration of rust and damage to fixtures.

England’s Chief Inspector of Hospitals, Professor Ted Baker, said:

“There has been some improvement in care at Imperial College Healthcare NHS Trust and the quality of some services are outstanding. However, there is still plenty of scope for the ratings of the trust to improve."

“I hope that before future inspections the trust can make further improvements so that it can achieve an overall rating of Good rather than Requires Improvement.”

You can read the latest reports in full on our website.

Last updated:
21 February 2018

Notes to editors

ICHT has 12 registered locations and employs almost, 11,000 staff. The trust serves a population of up to two million people and has a total of 1,412 inpatient beds spread across its various locations.

Whenever CQC inspects it will always ask the following five questions of every service:
  • Are they safe?
  • Are they effective?
  • Are they caring?
  • Are they responsive to people’s needs?
  • Are they well-led?

Under CQC’s current programme of inspections, we aim to inspect every NHS trust at least once between June 2017 and spring 2019. We use information that we hold on each trust to inform our decision about when and what to inspect.

During the unannounced inspection we will normally look in detail at certain core services - based on previous inspection findings, as well as wider intelligence - followed by an inspection of how well-led a provider is.

Our previous inspections of NHS trusts have shown a strong link between the quality of overall management of a trust and the quality of its services. For that reason, all trust inspections now include inspection of the well-led key question at the trust level.

Each inspection team is led by a member of CQC’s staff and includes specialist professional advisors such as clinicians and pharmacists. Where appropriate, an inspection team will also include Experts by Experience. These are people who have experienced care personally or experience of caring for someone who has received a particular type of care.

How CQC monitors, inspects and regulates NHS trusts

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.