Lewisham and Greenwich NHS Trust has been rated Requires Improvement overall by the Care Quality Commission. The trust’s rating remains unchanged from the last inspection in 2017.
The trust, which serves a population of more than half a million people, was rated Requires Improvement for being safe, effective, responsive and well-led. It was rated Good for being caring, after the inspection in September 2018.
The trust has two major hospitals: University Hospital Lewisham and Queen Elizabeth Hospital in Greenwich. CQC inspected several core services: the Emergency Department, maternity, surgery, end of life care at Queen Elizabeth Hospital (QEH) and University Hospital Lewisham and critical care at QEH.
At this inspection CQC did find some improvement in most of the services inspected since the previous inspections in 2015 and 2017. However, the trust acknowledged that many challenges existed throughout services.
A new Chief Executive and Chief Nurse were appointed in April 2018 and staff at all levels were positive about these appointments, describing improved communication and engagement. The executive team were making changes to strengthen the clinical leadership and inspectors could see some of these changes during the inspection.
CQC observed staff providing compassionate care and being attentive towards patients who spoke positively about the staff and the care they received. They said staff were friendly and helpful.
Staff provided patients with information about their care and treatment and involved them in decisions about their care. Responses from the Family and Friends test showed that patients would generally recommend the trust.
Areas where the trust must now improve include:
- Ensuring there are sufficient staff with appropriate skills and experience in all services to meet the needs of patients and provide safe, quality care and treatment.
- In surgery at QEH the trust needs to improve medicines management within the surgical division.
- Ensuring the critical care unit at QEH is meeting Faculty of Intensive Care Medicine standards for consultant to patient ratio.
- In the emergency department at University Hospital Lewisham, the provider must ensure all aspects of medicines are managed safely.
- In surgery at University Hospital Lewisham the trust must improve medicine management overall within the surgical division.
The executive team were aware of the challenges they faced and were committed to putting the right structures in place to deliver the changes and improvements needed for staff and patients. The trust engaged with patient user groups to obtain their views.
CQC’s Chief Inspector of Hospitals, Professor Ted Baker, said: “There has been some improvement in the quality of care in some areas at Lewisham and Greenwich NHS Trust.
“The strengthened leadership team needs to drive marked improvement in the trust’s ratings in the future and with that in mind we will continue to monitor the trust’s progress carefully.”
You can read the reports in full when they are published on CQC’s website at: www.cqc.org.uk/provider/RJ2
CQC has also published the trust’s Use of Resources report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as Requires for using its resources productively.
The combined rating for the trust, taking into account CQC’s inspection for the quality of services and NHSI’s assessment of Use of Resources is Requires Improvement.
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