The Hillingdon Hospitals NHS Foundation Trust rated as Requires Improvement by Chief Inspector of Hospitals

England’s Chief Inspector of Hospitals has rated the services provided by The Hillingdon Hospitals NHS Foundation Trust as Requires Improvement overall following an inspection by the Care Quality Commission in October.

Overall, the trust’s services were rated as Good for being caring, but as Requires Improvement for being effective, responsive and well led, and as Inadequate for being safe. As a result of the inspection, the trust was issued with two warning notices to demand improvements.

Full reports from the inspection, including ratings for all core services provided at Hillingdon Hospital and Mount Vernon Hospital are available at: www.cqc.org.uk/provider/RAS.

Inspectors found that the trust had a committed workforce, and was meeting national targets for waiting times across its emergency care provision at both hospitals.

While inspectors did not witness patients coming to actual harm, CQC identified a number of concerns, which presented a risk to patient safety at the trust due to the failures of systems and processes. While the trust was aware of many of the risks identified and had logged these on the corporate risk registers, insufficient action had been taken to date.

CQC’s concerns included the trust’s failure to comply with infection prevention and control standards. There was a significant shortage of nursing staff which was compounded by additional wards being open. The trust was failing to assess and monitor the quality of care effectively.

CQC also rated each hospital individually.

Hillingdon Hospital was rated Requires Improvement overall. It was rated as Requires Improvement for accident and emergency (A&E), medical care, surgery, critical care, maternity and family planning, children’s care, end of life care and outpatient services.

Mount Vernon Hospital was also rated as Requires Improvement overall by inspectors. CQC rated A&E, medical care, surgery and outpatient services at the hospital as Requires Improvement.

CQC identified a number of areas where the trust must make improvements, including:

• Making sure it complies with infection prevention and control standards, and that it monitors cleanliness against national standards.
• Assuring itself that the ventilation of operating theatres meets required standards.
• Addressing staff shortages across the trust, and making sure that agency staff receive an appropriate local induction on wards.
• Making sure that trust premises are secure, and that maternity and children’s areas and wards cannot be accessed by the public without staff knowledge and challenge.
• Making sure that all staff receive all mandatory training that is required to minimise risks to patient safety.
• Making sure that patient records are accurately and appropriately maintained, are kept securely, and can be located promptly when required. Making sure that patients are protected against the risks associated with the unsafe use and management of medicines, unsafe or unsuitable premises, or poorly maintained, unsufficient or unsuitable equipment.

Inspectors also identified good practice, including:

• Nurse practitioners in the Minor Injuries Unit, who made direct referrals to specialities both internally and externally to the hospital.
• Specialist care for children with diabetes, specifically the outreach work into schools.
• Good access to physiotherapy and occupational therapy and good multidisciplinary team working for surgical patients at Mount Vernon Hospital.
• Good multidisciplinary team working to support one stop outpatient clinics.
• Trainee doctors commented positively on the support and mentorship they received while working at the trust.

The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“When we inspected the hospitals run by the Hillingdon Hospitals NHS Foundation Trust, we saw that the trust had failed to take sufficient action on a number of matters of patient safety which they had already identified as presenting a risk.

“We saw that the workforce at the trust was committed and we saw some examples of good practice. The trust must build on these areas and work harder on managing risks to patients effectively.

“People are entitled to receive treatment and care in services which are consistently safe, effective, caring and responsive to their needs. We will return in due course to check that the improvements we have identified have been made.”

The inspection team, which included doctors, nurses, hospital managers, trained members of the public, CQC inspectors and analysts, visited the hospitals over a period of five days. They also made unannounced visits as part of the inspection.

Ends

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