Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) has been rated Good overall by the Care Quality Commission. This overall rating is unchanged.
The trust was rated Outstanding for being effective and caring. It was rated Good for being responsive and well-led, and Requires Improvement for being safe, following the inspection in October and November 2019.
CQC carried out the unannounced core service inspection in early October 2019. CQC inspected the core services of critical care, surgery and child and adolescent mental health services. CQC inspected how well-led the trust was in November 2019.
CQC inspectors found numerous areas of Outstanding practice. GOSH had recently started using pioneering 3D heart modelling and virtual reality to support complex cardiac surgery. Use of a virtual reality model of a patient’s heart has been shown to assist clinicians to virtually plan and practice complex procedures ahead of surgery, reducing the risk of complications and improving outcomes.
In collaboration with a local acute NHS trust and university, the surgeons successfully performed specialist foetal surgery, on a baby with spina bifida. This was the first time this surgery had been performed in the UK.
GOSH participated in an initiative allowing children with complex needs and long-term conditions to become trainee biomedical scientists for the day. This helped children gain a better understanding of what happens to their blood samples.
The trust had a range of services to support children and young people who were frightened, confused or phobic about aspects of their care and treatment. Play staff held blood parties using disco lights and sensory equipment to distract patients while they were taking blood.
The culture of the services provided were centred on the needs and experiences of children, young people and their families who used them. GOSH had an open culture where children, young people, their families and staff could raise concerns without fear.
Leaders and staff actively and openly engaged with children, young people and their families, equality groups, the public and local and national organisations to plan and manage services. They collaborated with partner organisations to help improve services for patients.
The trust’s young people’s forum actively engaged with young people and their siblings to ensure their views and experiences influenced and informed service developments in the trust.
The trust had held two ‘Play Street’ events in July and October 2019, as part of the local clean air campaign, which the local council was very supportive of. The road outside the hospital was closed to traffic and games and activities were provided. This event not only promoted clean air and the benefits to children but provided an opportunity to engage with the local schools who attended.
However, CQC’s rating for safe went down from Good to Requires improvement.
- Some services did not always control infection risk well. Staff used equipment and control measures inconsistently, they did not always use hand sanitisers when entering or leaving the wards, or when moving between patient bays.
- In some clinical areas, systems to ensure equipment was maintained and safe to use were not effective and did not always follow national guidance.
- Pharmacy provision on the critical care wards was below that recommended by the Society of Critical Care Medicine.
Professor Ted Baker, England’s Chief Inspector of Hospitals, said: “Great Ormond Street Hospital for Children NHS Foundation Trust, has a worldwide reputation for the work it does caring for sick children.
“While I am please it has retained its Good overall rating, the trust needs to put more effort to improving the consistency of its management of patient safety. That said I was impressed with some of the Outstanding care inspectors witnessed. Critical care staff were lead authors on four of the eight multiple centre trials published globally in paediatric intensive care in 2018 and 2019. They were the largest global contributor from any the paediatric intensive care units.”
You can read the report in full when it is published on CQC’s website at: www.cqc.org.uk/provider/RP4
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