St George’s University Hospitals NHS Foundation Trust has been rated Requires Improvement overall by the Care Quality Commission and remains in special measures. Previously it was rated Inadequate.
St George’s was rated Requires Improvement for being safe, effective, responsive and well-led. It was rated Good for being caring, following the inspection that took place in March and April 2018.
The trust is a teaching trust with two hospital locations; St George’s Hospital, Tooting, and Queen Mary’s Hospital, Roehampton. The main acute site is St George’s Hospital, which provides general and specialist services and has an emergency department, major trauma centre and hyper-acute stroke unit. CQC visited both locations during this inspection.
At St George’s Hospital, the CQC inspected the core services of urgent and emergency services, medical care, surgery, services for children and young people and outpatients, as part of our continual checks on the safety and quality of healthcare services. At Queen Mary’s Hospital, CQC inspected community inpatients, surgery and outpatients.
Inspectors did find some examples of outstanding and innovative practice at the trust. At St George’s Hospital, the bariatric surgery team had streamlined the patient pathway for gastric bypass patients, allowing them to carry out the first day surgery gastric bypass in the UK. The paediatric intensive care unit had better than average patient outcomes when compared with similar units despite the high number of patients cared for.
At Queen Mary’s Hospital the orthotics department had received a Bureau Veritas certificate which was an international certificate that demonstrated excellence and a drive for continuous improvement within the department. The orthotics department also met greater than 90% of the national targets.
However, there are areas where the trust must improve. At St George’s Hospital these include:
- Ensuring the needs of people living with mental health issues are met.
- Reviewing and monitoring mental health patients who are subject to the use of restraint and/or rapid tranquillisation in line with National Institute for Health and Care guidance.
- Continuing to work to ensure that operating theatres are fit for purpose.
- Ensuring all incidents are reported to enable appropriate oversight.
- Reviewing the storage of medical records in all clinics to ensure that they cannot be accessed by unauthorised persons.
- In services for children and young people at St George’s Hospital the trust must ensure there are sufficient numbers of suitably qualified staff on each shift to provide safe care.
At Queen Mary’s Hospital the trust must ensure the surgery department:
- Complies with the World Health Organisation surgical safety checklist.
- Ensure staff following the trust’s policy in relation to swab and instrument count.
- Ensure staff use a recognised tool for monitoring deteriorating patients and a policy is made available for the treatment/transfer of patients who deteriorate and require a higher level of care.
Ted Baker, England’s Chief Inspector of Hospitals said:
“St George’s has made significant progress since our last inspection and addressed many of the challenges facing the trust. As a result its overall rating has improved from Inadequate to Requires Improvement. The new executive team recognises that more improvement to the quality of care is still required.
“We will check that the trust takes further action to improve its services and will be returning to inspect again soon. We will monitor the safety and quality of services through our continuing relationship with the trust and our regular inspections.”
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St George’s has made significant progress since our last inspection and addressed many of the challenges facing the trust
Professor Ted Baker, Chief Inspector of Hospitals