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UCLH told to tackle A&E overcrowding and theatre safety

Inspectors have criticised University College London Hospitals NHS Foundation Trust for failing to follow safe surgery procedures and its overcrowded accident and emergency premises – but judged care overall as excellent.

The Care Quality Commission’s chief inspector of hospitals, Professor Sir Mike Richards, today published a report on the quality of care provided by the trust following an inspection in November.

Overall, the inspection team – including doctors, nurses and specialists – found services run by the trust were “safe, effective, caring, responsive to patients’ needs and well-led”.

Inspectors saw many examples of good care, and were impressed by the dedication shown by staff and the emphasis at all levels of the trust on putting patients first, the CQC said.

The vast majority of patients were also very positive about the care they received and staff told inspectors they were proud to work at the trust.

However, the inspection team also noted four areas where staff were delivering care under pressure and where the environment was not at an appropriate standard.

A&E staff were delivering safe care in “very difficult circumstances”, the CQC report said. The physical environment was considered inadequate due to shortage of space, facilities and equipment.

Patients were routinely doubled up in cubicles designed for one patient only, which severely compromised their privacy and dignity, and meant only one patient at a time had access to monitoring equipment. There was a “big risk of cross infection” from this practice, the CQC warned.

Despite these problems, the CQC praised the commitment of staff in A&E to good care.

Meanwhile, the inspectors found the World Health Organization checklist, designed to ensure safer surgery, was not always being fully completed by theatre staff.

In addition, the outpatient clinic was not adequately managed, resulting in overcrowding and patients left without seating in busy periods.

The trust was also failing to ensure paperwork was always completed for patients who had been assessed as not requiring resuscitation.

Areas of good practice identified included examples of caring, efficient staff showing good multi-disciplinary working in critical care, and excellent caring staff on the acute medical wards, including positive caring interactions with patients.

Sir Mike said: “My team saw many examples of good care, and were impressed by the dedication shown by staff, the support provided to staff, and the clear emphasis the trust places on putting patients first.

Sir Mike Richards

“The vast majority of patients spoken to were very positive about the care they received, and staff were proud to work at the trust and of the level of care they were able to deliver.

“Our judgement is that this is an excellent hospital in many ways – but the failings we identified are preventing it from achieving excellence across the board.”

In a statement, the trust said it was “totally committed” to improvement and had already begun taking action on each of the points raised in the report.

Trust chief executive Sir Robert Naylor said: “We are pleased that the inspectors recognised the commitment of our staff to delivering the best possible experience for our patients. We are proud that they found many examples of good care and teamwork.”

University College London Hospitals was one of the first trusts to be inspected under the CQC’s new programme, which is designed to provide a more detailed picture of care in hospitals and includes focus groups with staff and public listening events.

 

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Readers' comments (1)

  • I feel sorry for the Trust, they are being asked to continually maintain and improve services which are under considerable over demand. All this with year on year cuts to budgets.

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