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Flagship specialist trust rated 'requires improvement' by CQC

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The high profile specialist provider Royal Brompton and Harefield NHS Foundation Trust has been given a “requires improvement” rating by the Care Quality Commission.

The trust, which operates from the Royal Brompton Hospital in Chelsea and the Harefield Hospital, was told to improve on staff monitoring for patient deterioration and also surgical safety procedures.

“We appreciate that there are areas where we need to improve”

Bob Bell

The regulator rated the trust overall as “requires improvement” in a report published today, following an inspection in June. Although the specialist heart and lung trust was given “good” ratings in the effective, caring and well-led categories, it received a “requires improvement” rating for being safe and responsive.

The CQC’s report noted very good clinical outcomes for patients but said there was “poor” completion of the World Health Organization surgical checklist and that visitors were not reminded clearly enough to use antibacterial hand sanitiser.

The regulator said inspectors saw evidence of excellent outcomes for transplants, heart failure and extracorporeal membrane oxygenation but found that the trust had only just started reporting critical care outcomes data, making comparison with other units impossible on this measure.

The CQC’s chief inspector of hospitals professor Sir Mike Richards said: ”We found patients received compassionate care by staff who spoke about their trust with passion and pride. There are many people who owe their lives to the dedication and expertise of their staff.

“However, there are areas for improvement. I note that critical care services have not in the past submitted data for national audit – which means that it has been difficult to compare the trust’s quality of care with other hospitals,” he said.

Mike Richards

Mike Richards

Mike Richards

He added: “I am concerned that there was poor completion of the WHO safer surgery checklist at both hospitals, despite discussions among the staff about patient safety risks.

“The trust must also take greater care to ensure that clinical staff are monitoring patients whose condition may deteriorate, using the standard National Early Warning Score charts,” said Sir Mike.

The Royal Brompton is one of the trusts that faces losing congenital heart disease services under criteria drawn up by NHS England. 

Chief executive Bob Bell said in a statement: “We appreciate that there are areas where we need to improve. We know what they are, have already made progress with some of them and are developing robust action plans for others.

“We are confident that within a short timeframe significant improvements are possible and we will be reporting our progress to our board on a regular basis,” he added.

The trust has around 512 inpatient beds, of which 360 are general acute beds, 59 paediatric beds and 93 critical care beds. It delivers in the region of 38,619 inpatient admissions and 178,495 outpatient attendances. It employs in the region of 3,298 staff.


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