The Hillingdon Hospitals NHS Foundation Trust

Ratings - Well-led

• Well-led Our assessments of NHS trusts now focus on leadership. We no longer rate trusts overall for their safety, effectiveness and responsiveness or how caring they are. We do still publish those ratings for the services they provide.

  Requires improvement

Our view of the service

The Hillingdon Hospitals NHS Foundation trust (the trust) provides services from both Hillingdon Hospital and Mount Vernon Hospital. The trust has a turnover of around c357 million and employs over 3,500 staff. They deliver healthcare to the residents of the London Borough of Hillingdon and to those living in the surrounding areas of Ealing, Harrow, Buckinghamshire, and Hertfordshire.

The Hillingdon Hospital provides a full range of hospital services including emergency care, critical care, elective and non-elective general medicine (including elderly care) and surgery, as well as outpatient and diagnostic imaging services. The Mount Vernon campus provides minor injuries services, inpatient, outpatient, and day surgery services and is the location of a specialist neuro-rehabilitation unit. The trust is a member of the Northwest London Integrated Care System (ICS) and a member of the Northwest London Acute Provider Collaborative alongside Chelsea and Westminster NHS Foundation Trust, London Northwest University Healthcare NHS Trust, and Imperial College Healthcare NHS Trust. The collaborative has a Chair in Common, however, the trust remains a sovereign and separate organisation, responsible for delivering their own budgets and performance standards.

The trust is part of Hillingdon Health and Care Partners (HHCP). The HHCP, founded in 2017, is a partnership between the trust, Central North West London NHS Foundation Trust, Hillingdon Primary Care Confederation, and Hillingdon H4All. Place-based partnerships bring together local authorities, hospital providers, mental health, community, and primary care services with charitable and voluntary organisations to deliver models of care that better support residents in their own homes, reduce inappropriate use of hospital care, and support patients to return home faster.

We assessed all 8 of the quality statements in the well-led key question used when assessing an NHS trust using our current framework. We reviewed evidence for quality statements in line with published evidence categories. The well-led review followed assessments of the trust’s front-line services (assessment service groups - ASGs). The locations and ASGs we assessed included Urgent and Emergency Care and Surgery at Hillingdon Hospital and Mount Vernon Hospital. We undertook these assessments to ensure we had a thorough understanding of the full range of services provided by the trust ahead of our well-led review. The initial assessment of the trust’s services was triggered by the length of time since our previous inspection.

People's experience of this service

Patients across The Hillingdon Hospitals NHS Foundation Trust generally received care from dedicated and compassionate staff who worked hard to provide safe and responsive services, despite operational and financial pressures. Feedback from patients and their families reflected positive experiences in areas such as kindness, dignity, and access to support, with multiple examples of staff demonstrating respectful and person-centred care. However, ongoing challenges within the trust’s governance, and workforce culture sometimes impacted the consistency and quality of care delivery. Although efforts were made to listen to patients and families, the mechanisms to respond to feedback and implement change were not always effective or timely. These limitations meant that patients did not consistently experience the level of responsiveness they should expect. Patients’ experiences were influenced by ageing estates and delays in treatment access, though recent approvals for redevelopment and investment signalled future improvements. Overall, while the trust demonstrated a strong ethos of patient care, further improvements in governance, inclusion, and system responsiveness are necessary to ensure consistently high-quality experiences for all who use the service.