CQC rating

The Care Quality Commission (CQC) is the independent regulator of healthcare services in England. The CQC works with NHS organisations like us to make sure we provide people with safe, effective, compassionate and high-quality care.

The Care Quality Commission (CQC) is the independent regulator of healthcare services in England. The CQC works with NHS organisations like us to make sure we provide people with safe, effective, compassionate and high-quality care.

Services are assessed according to the CQC’s five domains: Safe, Effective, Caring, Responsive and Well-led.

Services are then rated. The categories for ratings are: Inadequate, Requires improvement, Good and Outstanding.  These ratings are then added up to produce an overall rating for each hospital, as well as a rating for the Trust overall. Further information on our Trust-wide rating can be found below. 

Latest CQC inspection: July 2023

Imperial College Healthcare NHS Trust's maternity services continue to be rated as outstanding, following Care Quality Commission (CQC) inspections in March 2023 which were published on 20 July 2023. The ratings cover both the Trust’s NHS and private maternity services. 

The inspections took place at Queen Charlotte’s and Chelsea and St Mary's hospitals, as part of the CQC’s national maternity services inspection programme. This programme will provide an up-to-date view of the quality of hospital maternity care across the country, and a better understanding of what is working well to support learning and improvement.

Following this focused inspection, the overall rating for the maternity services at both Queen Charlotte’s and Chelsea and St Mary's hospitals remains as outstanding overall, and good for how well-led and safe the services are. This is the same rating that the CQC gave the Trust’s maternity services in 2019, when the last inspection took place. 

The overall rating for Queen Charlotte’s and Chelsea Hospital is unchanged by this inspection and remains outstanding. The overall ratings for St Mary’s Hospital and Imperial College Healthcare NHS Trust are also unchanged and remain requires improvement. 

Previous CQC inspection: February 2019

In February 2019, the CQC inspected: critical care at Hammersmith, St Mary's and Charing Cross hospitals; maternity at Queen Charlotte's and Chelsea and St Mary's hospitals; children and young peoples' services at Hammersmith and St Mary's hospitals; neonatal services at Queen Charlotte's and Chelsea hospital.

The improved ratings mean that Queen Charlotte’s & Chelsea also becomes the first of the Trust’s hospitals to be rated as ‘outstanding’ overall. The other hospitals – and the Trust overall – will stay at their current ratings until further services have been inspected.

The Care Quality Commission (CQC) has also improved its rating for how ‘well-led’ the Trust is overall following a separate inspection in April 2019 – up from ‘requires improvement’ to ‘good’. In addition, NHS Improvement inspected how well the Trust uses its resources to provide high quality and sustainable care for patients for the first time in February 2019 and has given a rating of ‘good’.

Overall ratings for services at each site that were inspected by the CQC in February 2019, compared with their previous inspection of these services, are as follows:

• Critical care at Charing Cross – ‘good’, an improvement from ‘requires improvement’ in 2014
• Critical care at Hammersmith – ‘good’, an improvement from ‘requires improvement’ in 2014
• Children and young people services at Hammersmith Hospital – ‘good’, an improvement from ‘requires improvement’ in 2014
• Maternity at Queen Charlotte’s & Chelsea – ‘outstanding’, an improvement from ‘good’ in 2014
• Children and young people services St Mary’s – ‘good’, the same rating as 2014
• Critical care at St Mary’s – ‘good’, the same rating as 2014
• Maternity at St Mary’s – ‘outstanding’, an improvement from ‘requires improvement’ in 2017
• Neonatal services at Queen Charlotte’s & Chelsea – ‘good’, an improvement from ‘requires improvement’ in 2014

CQC inspections in November and December 2017 

In November 2017 the CQC inspected urgent and emergency services at St Mary’s and Charing Cross hospitals, and surgery at St Mary’s, Charing Cross and Hammersmith hospitals. In December 2017 the Trust had its first inspection of the well-led domain at Trust level. The inspection reports highlight outstanding aspects of care while also calling for some immediate improvements.

The overall rating for urgent and emergency services at St Mary’s Hospital remained the same at ‘requires improvement’ while the overall rating for the service at Charing Cross Hospital worsened, from ‘good’ in 2014 to ‘requires improvement’.

The overall rating for surgery at St Mary’s and Charing Cross hospitals remained the same at ‘requires improvement’. The overall rating for surgery at Hammersmith Hospital improved to ‘good’ since the last inspection in 2014.

The Trust’s overall rating for the well-led domain was ‘requires improvement’. Although this rating resulted from the new style inspection, it is the same as the rating following the last Trust-wide inspection in 2014.

All of the inspection reports and ratings for Trust services are published on the CQC's website.

Areas of outstanding practice

Urgent and emergency services:

• The major trauma centre within the department achieved good outcomes in the Trauma Audit & Research Network (TARN) audit. The trauma department was part of the ‘Redthread’ youth violence intervention programme, which ensured seven-day support from a youth worker embedded in the hospital. Any practitioner could refer a child or young person brought into the department where there was a suspicion of violence, assault and/or exploitation as their index admission reason. As a major trauma centre for patients with gunshots or stab wounds, the hospital had developed a new patient pathway based on military medical techniques. Staff were undergoing teaching, scenarios and desktop exercises designed to help them deal with major trauma and incidents more effectively.
• A dedicated full-time play specialist worked in the ED to support children whilst receiving treatment. Volunteers were well placed in the paediatric ED waiting area helping to supervise and play with the children whilst they waited to be seen.

Surgery:

• The division planned to implement a lead matron for mental health to ensure patients with rehabilitation needs following trauma were fully supported.
• A surgery team had been awarded a British Medical Journal prize in recognition of an innovative ‘prepare for surgery' programme that aimed to reduce the length of hospital stays. The programme aimed to improve multidisciplinary input from psychology, nutrition and exercise prior to surgery.
• The surgery division was research active and was awarded significant research funding each year that staff used to drive forward innovative practice. This included a recent breath test trial for oesophageal cancer diagnosis.
• The waiting list improvement programme (WLIP) was based on the Trust’s recognition that a key need for the future was sustainability of services.
• The QI team worked with the Royal Academy of Arts to support staff that had innovative ideas for improvement and development to be able to design and implement these in a dedicated environment.
• Staff who worked in link roles spoke positively of their work, which included continually improving services and training. For example, a healthcare assistant in Charles Pannett ward was part of a link team for improving nursing handovers. This team had submitted a new handover briefing sheet to the senior ward team for consideration.
• The Trust’s PREPARE for surgery programme was designed to improve patients’ condition undergoing surgery. It looked at different factors to focus on before and after a procedure, including physical activity, diet, psychological wellbeing and medication management. The PREPARE for surgery team had been named Patient Partnership and Surgical Team of the Year at the British Medical Journal (BMJ) Awards 2017.
• The hepato-biliary service provided a specialised tertiary service for procedures such as ‘Whipples’ surgery for pancreatic cancer. Nurses on the hepato-biliary ward had developed specialist knowledge and skills to care for patients with complex symptoms.
• The chest pain pathway provided rapid access via the heart attack centre to cardiac catheterisation including trans aortic valve replacement (TAVI), a relatively new technique pioneered at Hammersmith. The pathway also provided patients with access to cardiac surgery. Cardiac services were being consolidated on the Hammersmith site to provide a specialist cardiac service. New roles such as advanced nurse practitioners had been developed to support implementation of the pathway to provide specialist skills.

Well-led at Trust level:

• The Trust’s role as a leader in the adoption of digital technologies to improve patient care was recognised in March 2017 when, in partnership with a neighbouring NHS foundation trust, the Trust was selected by NHS England to be one of 16 global digital exemplars in acute care. As a global digital exemplar, the trust receives funding and support to drive forward the use of digital technology and create products and approaches that can be used by other organisations.

CQC 2017 national survey of maternity services

The CQC published its bi-annual national survey of maternity services on 30 January 2018 which included feedback from patients at Queen Charlotte’s and Chelsea Hospital and St Mary’s Hospital. The Trust has improved on a number of measures and performed ‘about the same’ as other trusts in England. 

CQC 2016 national survey of children's services

The CQC published its annual national survey of children’s services on 28 November 2017. The survey covered paediatric inpatient and day case patients who had been discharged from our Trust between November and December 2016. The Trust performed ‘about the same’ as other trusts in England based on the 260 responses received.

CQC 2016 national survey of emergency departments

The CQC published its annual national survey of emergency departments on 17 October 2017. The Trust was identified as performing 'worse than expected' from responses provided by 240 patients who used the Charing Cross or St Mary's emergency department during September 2016.

For further information please read our news release.