Dying patients were left in pain by staff at Whipps Cross University Hospital, according to inspectors who identified “many examples of a lack of compassion” during a recent visit.
The hospital in Waltham Forest, East London, which is part of Barts Health Trust, was once again rated “inadequate” overall after an inspection that took place in July and August this year.
“They were visibly distressed and told us they did not feel supported”
The Care Quality Commission found “tangible improvements in safety and effectiveness” during the visit and said the hospital was “moving in the right direction”.
However, its inspection of eight core services revealed serious concerns about the quality of care in some areas including end of life care, which was rated “requires improvement”.
“We observed some patients were visibly in pain, but staff did not respond to this by providing them with adequate analgesia,” stated the CQC’s report on Whipps Cross, which wa published today.
“There were examples of lack of compassionate care,” it said. “One patient looked dirty with stains all down the front of their nightwear and staff had neither noticed it nor took any actions to wash and care for the patient.”
Inspections also found “pockets of poor culture with evidence of bullying and inequality” at the hospital, which was also rated “inadequate” for being well-led.
“A number of nursing staff in different surgical areas told us about ongoing issues of bullying and harassment,” said the CQC report.
“They were visibly distressed and told us they did not feel supported by their managers and service leaders. They felt the trust was not supportive of whistle-blowers. They gave us examples when they were blamed for and unprofessionally treated after raising an issue or a complaint. Nursing staff felt they were not valued, appreciated or recognised,” it added.
“We must tackle all the areas where we are still letting out patients down”
Other areas in need of improvement included bed management, discharge arrangements, and infection control, said the regulator.
The trust – currently in the special measures support regime for struggling healthcare providers – was also told it must address staffing and staff training issues, including ensuring staff had the right skills to recognise when patients’ condition was deteriorating.
The report identified seven serious incidents reported in emergency and urgent care services between August 2015 and July 2016 – including four incidents of “poor care” that each resulted in a “potentially avoidable patient death”.
“In each case, there was a delay in either assessing, diagnosing or escalating a deteriorating patient,” said the report.
However, inspectors also found real improvement in some areas, with maternity and gynaecology and services for young people and children rated “good”.
The report on Whipps Cross was published at the same time as another CQC inspection report on the Royal London hospital, which is also run by Barts Health NHS Trust.
“There has been an exceptional amount of hard work by clinical and support staff”
In contrast, it was judged to have improved its overall rating from “inadequate” to “requires improvement”.
Barts Health chief executive Alwen Williams, who has been in the post for about 18 months, said the two reports indicated the quality of care at both hospitals was “getting better all the time”, with increased quality ratings for 28 indicators across the two organisations.
She said immediate action had been taken to address concerns raised by CQC inspectors, with developments including the employment of 275 more permanent doctors and nurses at the trust since the end of July.
“I’m very grateful for the dedication and passion our staff show every day and night,” she said. “We still have much to do and we must tackle all the areas where we are still letting out patients down, as well as taking inspiration from where we are doing well.
Damning report on care at major London hospital
“I am confident that Barts Health is now on the right track and with the support of our partners and our committed workforce we will continue to improve,” she added.
Steve Russell, executive managing director for NHS Improvement London, highlighted the “exceptional amount of hard work by clinical and support staff”.
“Barts Health NHS Trust is the biggest NHS trust in England, and the new team took on a Herculean task when they committed to turning it round,” he said.
“Although there clearly remains some way to go, the leadership team and staff throughout the trust have established a strong foundation on which to build future improvements for patients and their families,” he added.