England’s Chief Inspector of Hospitals has told The Royal London Hospital it must make further improvements after a comprehensive inspection by the Care Quality Commission in July 2016. The hospital has been rated as Requires Improvement overall.
The Royal London was rated Requires Improvement for being for being safe, effective, caring, responsive and well-led.
Eight core services at The Royal London were inspected. Maternity and gynaecology was rated as Inadequate. Urgent and emergency services, medical care (including older people’s services), surgery, services for children and young people, end of life care and outpatients and diagnostic imaging were all rated as Requires Improvement. Critical care was rated as Good.
The Royal Hospital in Whitechapel, East London, is part of Barts Health NHS Trust, the largest NHS trust in the country, serving 2.5 million people across Tower Hamlets and surrounding areas of the City of London and East London.
CQC inspectors returned to inspect the hospital to follow up on previous inspections of Barts Health NHS Trust in 2014 and 2015 which had identified a number of concerns around patient safety and the quality of care. Following the last inspection, significant changes were made to the leadership of the organisation at both an executive and site level.
On the latest inspection CQC found that nursing staff vacancies across the hospital and theatre staff vacancies impacted on staff morale and in some case the quality of patient care.
A shortage of midwives meant that maternity wards were at times inadequately covered. There was also a low level of maternity consultant cover.
The security system for babies was not robust, with poor compliance to the wearing of baby name bands. The infant abduction policy had not been distributed to staff. The policy assumed the use of an electronic baby tagging system which was not in use in the hospital.
Professor Sir Mike Richards, Chief Inspector of Hospitals, said: “We were most concerned about the standard of care around maternity and gynaecology services. Staffing on maternity wards was sometimes inadequately covered – but most worrying of all was the lack of a safe and secure environment for new born babies. At the time of our inspection, we raised this with the Royal London Hospital as a matter for their urgent attention.
“On a positive note we saw several areas of outstanding practice. There was a strong record of innovation in the hospital’s trauma service and the trust was internationally recognised as an innovator and leader in research in this field. The emergency department had introduced a ‘Code Black’ protocol for patients who had severe head injuries. This was the first of its kind in the country and meant that appropriate patients had care led by neurological surgeon from the first time that they arrived in the department.
“We found the adult critical care unit delivered outstanding care. The service had also developed a programme of learning to ensure best practice and improve patient care for a frequently changing medical workforce.
The report identifies a number of areas for improvement including:
- The trust must urgently improve security in the maternity services
- There must be enough midwives on the delivery suite to provide safe care for all women and enough suitably qualified staff to meet the needs of patients across all core services.
The trust must ensure there are enough recovery staff suitably trained in high dependency support and advanced life support to safely care for post-operative patients at all times.
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