01.11.16
NHSI places major teaching trust in special measures
The trust responsible for one of the UK's largest teaching hospitals has been placed in special measures by NHS Improvement (NHSI) after a CQC inspection rated it as inadequate overall.
The CQC’s report, published today, found that St George’s University Hospitals NHS FT had inadequate safety and leadership and required improvement in its effectiveness and responsiveness. However, it was found to be good in caring for patients.
Immediately after the inspection, the CQC issued a warning notice to the trust, which comprises St George's and Queen Mary's hospitals in south west London, highlighting regulation breaches relating to safe and fit premises, consent under the Mental Capacity Act 2005, good governance, and the fit and proper persons requirement.
Professor Sir Mike Richards, England’s chief inspector of hospitals, said: “I am disappointed that we have found a marked deterioration in the safety and quality of some of the trust’s services since we inspected two years ago, as well as in its overall governance and leadership.
“I am satisfied that the executive team acknowledge the need for significant improvement across the board and are clear about the challenges they face. They will need external support which is why I have recommended that the trust be placed into special measures.”
CQC inspectors found that several of the trust’s buildings, including its emergency department and some of its operating theatres, were not fit for purpose for reasons including compromised privacy, poor fire detection systems and a risk of water contamination.
Inspectors also observed that infection control procedures were not properly followed and only half of the staff working with children and young people had completed adequate safeguarding training.
However, the trust was praised for the effectiveness of its maternity care and outcomes achieved by its specialist services, particularly those for renal patients which are some of the best in the country.
Following the release of the report, NHSI said it will provide a range of support to help the trust in its efforts to make the required improvements, including the development of a quality improvement plan; the appointment of an Improvement director to oversee the improvements; and assistance in progressing plans for urgent hospital estate repair work, in addition to operating theatres that have recently been repaired.
Steve Russell, executive regional managing director for London at NHSI, said the regulator recognises “the scale of work that is required to secure the level of improvement that is needed is significant and we are working with the trust to consider the necessary steps to ensure sustainable improvements are made”.
Earlier this year, NHSI’s predecessor Monitor said that it would have to tighten its internal process for granting foundation trust status to NHS providers after St George’s finances suddenly deteriorated shortly after receiving the FT label.
Responding to the latest CQC report, Sir David Henshaw, interim chair at St George’s, added that the trust has a new leadership team in place, and real progress has been made since June.
“However, as we’ve always said, there will be no quick fix to the problems we face,” he added.
“Many of these challenges are due to very poor Board and senior management decisions in the past, and a failure to tackle the big challenges head on. We owe it to our staff and patients to make St George’s better again, and the CQC’s report is a key part of this improvement journey.”
The inspection identified a number of areas for improvement for St George’s, advising that the trust must develop a long-term vision and ensure that its premises are safe and fit for purpose.
Since June, St George’s has appointed a new chief nurse and director of infection prevention and control as well as three new non-executive directors, investing £1.3m in new IT systems.
The trust has also restarted its estate maintenance programme, refurbished two operating theatres and moved a number of its outpatient services off site. Its emergency department is currently one of the best performing in London.
(Top image c. John Stillwell)
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