Services provided by Imperial College Healthcare NHS Trust have been rated overall as “requires Improvement” by the Care Quality Commission, with a lack of nursing staff a key theme.
Following an inspection in September, the trust’s services were rated as “good” for being effective and caring, but as “requires improvement” for being safe, responsive and well led.
Inspectors said patients were treated with dignity and respect by staff, felt involved in their care and that staff were compassionate and considered their individual care needs. Clinical outcomes for patients were good, and there was a clear commitment to multi-disciplinary working, they added.
“There is still more to do here to make sure that people receive the best possible care across the board”
But the CQC found nurse staffing levels were not sufficient in some areas, especially in medical wards, and there was a high reliance on bank and agency staff.
In addition, standards of cleanliness and infection control were inconsistent across the trust.
More work needed to be done to improve staff engagement, the CQC said, but added that staff had a clear sense of pride in their work.
CQC also rated each hospital inspected individually. Charing Cross Hospital, Hammersmith Hospital and St Mary’s Hospital were rated as “requiring improvement overall”, while Queen Charlotte’s and Chelsea Hospital was rated as “good overall”.
Problems relating to nurse staffing were highlighted by the CQC at all four of its general hospitals.
At St Mary’s, staff needed to be brought up to date with their mandatory training. At its Chelsea site, the trust was told to review staffing levels and take action to ensure they were in line with national guidance, and to review the capacity of its maternity and neonatal units.
At both Charing Cross and Hammersmith, the trust was told to address high vacancy rates for nursing staff and healthcare assistants in medical wards.
CQC’s Chief Inspector of Hospitals, Professor Sir Mike Richards, said: “We saw too much variation in the quality of services. Standards of cleanliness and management were inconsistent.
“The trust must take action to tackle surgical backlogs and to improve their systems to ensure people awaiting outpatient appointments do not experience unnecessary delays and inconvenience,” he said.
He added: “Across all the hospitals, we saw staff delivering compassionate care. While this is something of which the trust should be proud, there is still more to do here to make sure that people receive the best possible care across the board.”
The trust provides services to a population of around two million people across North West London from five locations – St Mary’s Hospital, Charing Cross Hospital, Hammersmith Hospital, Queen Charlotte and Chelsea Hospital, and the Western Eye Hospital. It employs around 10,000 staff.
Trust chief executive Dr Tracey Batten said: “While we are disappointed with our overall rating of ‘requires improvement’, we think the report is extremely constructive. It clearly sets out our challenges.
“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,” she said. “The CQC has now re-inspected St Mary’s A&E and has confirmed that the required improvements have been made.”
She added: “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. Our maternity and family planning services and our end of life care were rated as ‘good’.
“We have already begun work on an action plan in response to the CQC report, which is due to be submitted in mid January,” said Ms Batten.