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North East London NHS Foundation Trust Requires Improvement says CQC

27 September 2016
North East London NHS Foundation Trust
  • Media

England’s Chief Inspector of Hospitals has rated North East London NHS Foundation Trust as Requires Improvement.

The trust was rated Requires Improvement for being Safe, Effective, Responsive and Well-led. It was rated Good for Caring following the inspection in April.

North East London NHS Foundation Trust provides community health and mental health services in Essex and across the North East London Boroughs of Barking and Dagenham, Havering, Redbridge and Waltham Forest. It provides care and treatment for a population of about 1.75million and employs around 6,000 staff.

Care Quality Commission inspectors identified a number of areas where the trust must improve services as a priority. The child and mental health wards at the Brookside unit were a particular concern, says the report, in relation to staffing, restrictive practices, lack of incident reporting and lack of recovery orientated care planning.

Shortly after the inspection, the trust took action to temporarily close the Brookside unit after CQC issued a Warning Notice requiring significant improvements. It is scheduled to reopen this month.

Inspectors found that risks to mental health patients were not always dealt with properly. The trust had failed to ensure that the risks to patients at risk of suicide from ligature anchor points were identified, and made safe.

In the community health services there were major staffing shortages and recruitment challenges across all staff groups and localities. There were high caseloads for staff, high use of agency and bank staff, all which had an impact on the delivery of the services.

There was though, a well-established patient experience partnership group with direct links to the board to enable strategic developments for people using services.

The diabetes team in the Essex community health adults’ service had developed a number of initiatives to meet the needs of the local population more effectively. The team provided Skype appointments and telephone assessments depending on patient needs, and texted blood results to patients to spare them an appointment.

Dr Paul Lelliott, Deputy Chief Inspector of Hospitals and CQC lead for mental health, said: “There are many areas where North East London NHS Foundation Trust needs to improve. Also, the trust has not demonstrated that it learns from adverse incidents and has not taken appropriate steps across all of the mental health services to ensure that risks to patients are minimised.

“The trust must provide more training to staff on some important areas. In particular, I am concerned that the Mental Health Act was not part of the mandatory training for all staff in the mental health services. This is particularly important for staff who work regularly with patients who are detained under the Act. We also found that there was a lack of robust induction or training for the trust governors, which meant they might not be as effective as they could be in their role.

“However, directors and managers demonstrated commitment and enthusiasm to the trust and spoke passionately of the work being undertaken to develop services.

“The trust had taken positive action in response to the recent NHS staff survey to involve and engage staff more in the development of the trust. There was a well-established patient experience partnership group with direct links to the board to enable strategic developments for people using services.”

The report identifies a number of areas where the trust must improve which include:

  • The trust must reduce the use of restraint and prone restraint
  • It must ensure mental health staff are properly trained
  • The trust must ensure consistent patient access to psychological therapies
  • No restrictive practices throughout the child and adolescent mental health wards on Brookside unit
  • The trust must ensure that patients at Brookside unit are not secluded without proper safeguards in place
  • Searching of patients at the Brookside unit are carried out in accordance with a clear policy.


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Last updated:
29 May 2017

Notes to editors

During the announced inspection visit from the 4 – 8 April, and unannounced inspection on the 14 April 2016 the inspection team visited 62 wards, teams and clinics and spoke with 265 patients and people using services or their relatives and carers, either in person or by phone.

Inspectors visited all of the trust’s hospital locations and a sample of community health services. They inspected all wards across the trust including adult acute services, the psychiatric intensive care unit, community hospitals, the forensic ward, health centres and older people’s wards.

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.