Regulator's report slams Imperial College Healthcare NHS Trust

A damning new report by health regulator the Quality Care Commission has rated all three main hospitals run by Imperial College Healthcare NHS Trust - Charing Cross, Hammersmith and St Mary's - as "requires improvement".

Only the maternity hospital Queen Charlotte's & Chelsea Hospital achieved the higher rating of "good", though it also requires improvement in two areas, safety and leadership.

The A&E at St Mary's in Paddington, which is now used by patients from our borough since the A&E at Hammersmith Hospital in Shepherd's Bush was closed in September, was judged particularly harshly with the inspector rating it "inadequate".

Though the inspector found that care in the A&E was generally satisfactory, the report said: " The standards of cleaning and maintenance of some equipment was inadequate. The department had some issues with patient flow because of the A&E department’s physical capacity in relation to the number of patients it could accommodate.

" There was a lack of bed capacity for those who needed admission. We also had some concerns about the leadership in the A&E department and the lack of drive to improve patient experience on this site for the next five years."

By contrast, the A&E at Charing Cross Hospital - which is currently threatened with downgrading to an urgent care centre - was rated "good", with the inspector praising the safe and efficient operation, strong culture of learning and improving and the fact that staff were proud to be working there.

Overall, the report found that Imperial College Healthcare NHS Trust "requires improvement" in three areas - safety, with the inspector noting inconsistencies in cleanliness and infection control and nurse staffing levels; responsiveness, with criticism of waiting times and complaints management and leadership.

However, two areas - effectiveness of its services and patient care - were both judged "good".

You can read the full report here.

Responding to the inspection report, Trust chief executive Dr Tracey Batten says: " While we are disappointed with our overall rating of 'requires improvement', we think the report is extremely constructive. It clearly sets out our challenges while also recognising the positive impact of our work over the past year and highlighting the great care that we already provide.

" We acknowledge that there are a few areas, such as cleanliness in St Mary’s A&E, that have simply not been acceptable and there can be no excuse for that. But we want to assure patients that this is the exception and that we have acted immediately to address the most pressing issues raised. For example, we have already put in extra staff support and refurbished the A&E at St Mary’s Hospital – with new flooring and lighting, more sinks and additional cleaning rotas. The CQC has now re-inspected St Mary’s A&E and has confirmed that the required improvements have been made.

" Overall, the findings show that our major improvement programmes – such as speeding up our recruitment processes, investing in better patient admin and IT systems, making care pathways more patient centred and building staff leadership and engagement – are moving us in the right direction. It’s clear that we now have to redouble our efforts in a number of areas and services.

" The report also shows that there is a lot of great care and clinical practice that we can build on. Most importantly, our staff are consistently seen by patients as caring and compassionate. And we achieve some of the best results for patients, including in our specialist centres for stroke and major trauma, as well as one of the lowest rates of patient deaths in the whole of the country. Our maternity and gynaecology services and our end of life care were rated as good across the whole Trust.

" We have already begun work on an action plan in response to the CQC report, which is due to be submitted in mid January. We hope to work closely over the coming months with our partners and stakeholders, and especially with patients and local communities, to move all of our ratings to good and ultimately to outstanding. Our initial action plan will be presented at our next public Trust Board meeting on Wednesday 28 January 2015."

The report however, does cast yet more doubt on plans for the downgrading of Charing Cross Hospital. Reacting to the CQC’s report, Cllr Stephen Cowan, Leader of Hammersmith & Fulham Council, said: “This is a damning report which backs our view that closing Charing Cross Hospital’s A&E will put lives at risk.

" This comes just a few months after it emerged the Trust had serious financial problems and it raises wider questions about the competency of the people arguing for Charing Cross Hospital to become a much smaller urgent care clinic. We are determined to defend Charing Cross and our local NHS and this report demonstrates just why it’s vital we do that."

December 19, 2014