Care Quality Commission highlights outstanding aspects of care while also calling for some immediate improvements

Imperial College Healthcare NHS Trust is committed to making further improvements outlined in three Care Quality Commission service-level inspection reports, published today, Thursday 19 October 2017.

The inspection, which took place in March 2017, looked at medical care at Charing Cross, Hammersmith and St Mary’s hospitals and maternity services at St Mary’s Hospital. These services were last inspected in September 2014.

Services were rated overall as follows:

• Charing Cross Hospital (medical care) – ‘good’, up from ‘requires improvement’ in 2014
• Hammersmith Hospital (medical care) – ‘requires improvement’, no change from 2014
• St Mary’s Hospital (medical care) – ‘requires improvement’, no change from 2014
• St Mary’s Hospital (maternity services) – ‘requires improvement’, down from ‘good’ in 2014.
Areas of outstanding practice noted by the CQC include:

• Introducing the ‘side by side’ initiative by the Alzheimer's Society which helps people with dementia access recreational activities while in hospital.

• The development of a nutrition pathway to ensure vulnerable patients receive the food and drink they need while in hospital without losing the independence they had before hospital admission.

• The introduction of an award winning nurse-led cirrhosis clinic to improve the screening of patients at high risk of developing severe complications from substance misuse

The CQC reported that patients were very positive about their experiences on the medical wards, particularly regarding their interactions with staff. Inspectors observed positive interactions between staff and patients throughout the medical wards visited. In maternity, the CQC noted that consent to care and treatment was obtained in line with legislation and guidance and that staff were conscious of the need to protect the dignity and privacy of women in all areas of the service.

The CQC also highlighted that the Trust remains in the top five lowest-risk acute trusts in the UK for mortality rates and that Charing Cross was the second best performing hospital in the country in the Sentinel Stroke National Audit Programme (SSNAP) which assesses support to patients during and after a stroke.

The maternity report acknowledges an improved midwife to birth ratio and that the labour ward had 98 hours per week consultant presence, in line with Royal College recommendations.

However, there are a number of areas in which it was clear the Trust needs to make urgent improvements. These include:

• Ensuring that all services routinely follow the Trust’s medicine management policies.

• Improving our compliance with mandatory and specialist training, including safeguarding, resuscitation and bereavement training.

• Improving governance processes and structures in maternity, with all identified risks included on the maternity service’s risk register.

Commenting on the reports, chief executive Ian Dalton CBE said: “While there are some very clear priorities for improvement, there is also much that is positive to build on. The CQC acknowledged improvements in medicine across all of our sites since the last inspection, sufficiently so at Charing Cross to increase our rating there to good.

"Clearly, it is disappointing for maternity services at St Mary’s to be rated as ‘requires improvement’ though it is clear what we need to do to get back to good and, ultimately, to outstanding.

“Given the challenges of our old estate, an ambitious cost improvement programme and increasing urgent and emergency demand, the inspection findings reflect a tremendous amount of hard work and commitment from our staff. The teams are already focusing on pulling together a robust action plan to address the findings of the CQC as quickly as possible.”