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Regulator finds 'concerning' staff shortages at South London hospital trust

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Epsom and St Helier University Hospitals NHS Trust has been rated as “requires improvement”, following its first comprehensive inspection by the Care Quality Commission.

Significant staff shortages were found across a range of the trust’s services, which contributed the rating, said the CQC.

“The trust must ensure that there are suitable numbers of suitably qualified staff”

Mike Richards

A team of inspectors visited the trust’s two main hospitals, Epsom Hospital and St Helier Hospital in Sutton, over a seven-day period in November 2015.

Like the trust overall, both hospitals were rated as “requires improvement”, said the CQC in its report.

However, the South West London Elective Orthopaedic Centre, located on the Epsom Hospital campus, was awarded the CQC’s highest rating of “outstanding”.

The centre is run in partnership with a number of local trusts and is the largest hip and knee replacement centre in the UK and is one of the largest in Europe.

Meanwhile, the renal service – including the satellite dialysis units – outpatients and diagnostics, and end of life care were rated as “good”.

“We have robust plans in place to improve in all the areas that they identify”

Daniel Elkeles 

However, inspectors found there was a “significant shortfall” of staff in a number of areas, including critical care, medicine, surgery, services for children and young people and maternity services.

At the time of the inspection, the CQC noted the trust had embarked on a large recruitment drive to try and increase its numbers of medical, nursing and allied health professional staff.

In addition, the fabric of the St Helier building was described as difficult to maintain due to its age, which was affecting the overall patient experience.

Staff also reported difficulties in a range of areas, such as ensuring the building was hygienically clean and that spacing between bed spaces was in line with nationally recommended standards.

The trust lacked appropriately equipped side rooms and isolation facilities for patients with healthcare associated infections or deemed risk of acquiring one, said the regulator.

The CQC said it would present its findings to a “local quality summit” to develop a plan of action and recommendations based on the inspection team’s findings.

Sir Mike Richards

Sir Mike Richards

Sir Mike Richards

CQC chief inspector of hospitals Professor Mike Richards said: “The trust must ensure that there are suitable numbers of suitably qualified staff.

“I am concerned that staffing levels have been identified as contributing factors in the number of ward-based cardiac arrests last year,” he said. “And it is clear that staff shortages were affecting the ability of staff to consistently provide care that was individualised and compassionate.”

Sir Mike also said the CQC had raised “immediate concerns about the culture and leadership” of the critical care service, which the trust had responded to with a review.

However, he added: “The hospital has become one of the leading referral centres for the treatment of routine and complex joint replacements and fully deserves its ‘outstanding’ rating.”

The future of the trust and its two hospitals has been uncertain for around a decade, with a series of plans proposed and then mostly dropped. These have included a potential merger with a neighbouring trust and various redevelopments, one of which was for a new “super hospital”.

Epsom and St Helier University Hospitals NHS Trust

Regulator finds staff shortages at South London trust

Daniel Elkeles

Trust chief executive Daniel Elkeles said highlighted the challenge posed by the uncertainty about the hospitals’ future “over so many years and the poor quality of our buildings”.

But he said he recognised there were areas that needed to improve and he accepted all of the CQC’s findings.

“In our five year strategy, which we published in April 2015, we recognised that one of our challenges was to consistently provide high quality care across all of our services, and the CQC report confirms for us that we still have work to do to ensure that we are achieving this,” he said.

He added: “Many of the areas that they identified were already the subject of improvement programmes and CQC highlighting of them has helped us accelerate progress. We have robust plans in place to improve in all the areas that they identify.”

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