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CQC rates Imperial College NHS Trust as ‘require improvement’

Imperial College Healthcare NHS Trust – widely regarded as one of the best-performing in the country – actually ‘requires improvement’ in key areas, according to the Care Quality Commission (CQC). 

The trust, part of the prestigious though self-selecting Shelford Group of top trusts, was inspected by the CQC in September. 

Inspectors found inconsistent standards of cleanliness and infection control across the trust. Nurse staffing levels were not sufficient in some areas, especially in medical wards, and there was a high reliance on bank and agency staff. 

But on the positive side, people said that they 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. 

After the inspection, the CQC issued the trust, which runs Charing Cross, Hammersmith, Queen Charlotte’s & Chelsea and St Mary’s hospitals, with a formal warning in regards to cleanliness and hygiene issues in A&E at St Mary’s Hospital. However, inspectors have since returned to the hospital and have found that the required improvements to A&E there have been made. 

Despite this, the inspectors found that the surgical department at Hammersmith had a significant backlog of patients waiting for elective surgery. Referral times in some specialties had breached national targets on an ongoing basis. And inspectors found that appointment letters sometimes arrived late or not at all, and that internal targets regarding sending these out and responding to complaints were not consistently being met. 

Professor Sir Mike Richards, CQC’s chief inspector of hospitals, said: “When we inspected the hospitals run by Imperial College Healthcare NHS Trust, 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.” 

Responding to the latest CQC report, the trust’s chief executive, Dr Tracey Batten, said: “While we are disappointed with our overall rating of ‘requires improvement’, we think the report is extremely constructive. 

“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. But we want to assure patients that this is the exception and that we have acted immediately to address the most pressing issues raised. 

“We have already begun work on an action plan in response to the CQC report, which is due to be submitted in mid-January. We hope to work closely over the coming months with our partners and stakeholders, and especially with patients and local communities, to move all of our ratings to good and ultimately to outstanding. Our initial action plan will be presented at our next public Trust Board meeting on Wednesday 28 January 2015.” 

Imperial College Healthcare NHS Trust is one of the largest acute trusts in the country and, in partnership with Imperial College London, was the UK’s first Academic Health Science Centre (AHSC). The trust’s specialist eye hospital, The Western Eye Hospital, was not included in the latest CQC inspection, because of the nature of its services. 

Already under fire 

In recent months, ahead of the CQC’s report, the trust has come under fire for its emergency medicine service strategy, which is built around St Mary’s A&E being extended as the major acute centre for the region. 

On 10 September, the trust closed the A&E department at Hammersmith Hospital, leaving it with an urgent care centre, and there are plans to develop a GP-led ‘emergency service’ at Charing Cross Hospital by 2020. 

Hammersmith Labour MP Andy Slaughter said plans to replace Charing Cross’s A&E department “must be shelved” following the release of the “depressing” CQC report.  He said: “It would be madness to press ahead with the closure of Charing Cross A&E and the demolition of the hospital. West London cannot cope with the demands on its acute hospitals.” 

(Images: c. Imperial College NHS Trust) 

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