South West London’s St George’s University Hospitals NHS Foundation Trust has been rated Requires Improvement (RI) overall by the Care Quality Commission. CQC has recommended that the trust now be taken out of special measures.
St George’s, which is based in Tooting, was rated RI for being safe, effective, responsive and well-led. It was rated Good for being caring. At its last inspection the trust was also rated RI.
It is a teaching trust with two hospital locations; St George’s Hospital, Tooting, and Queen Mary’s Hospital, Roehampton.
At St George’s Hospital, CQC inspected the urgent and emergency department, medical care, surgery, services for children and young people and outpatients. At Queen Mary’s Hospital, surgery was inspected.
CQC selected the services for inclusion in this inspection based on those that were rated ‘Requires Improvement’ after the previous inspection carried out in March 2018.
At St George’s Hospital inspectors found evidence of outstanding practice in the emergency department. The ‘hot lab’ in the emergency department was able to produce a full blood count within minutes. This could have a significant benefit when treating patients with certain conditions and reduce the use of unnecessary broad-spectrum antibiotics. This also benefitted patients as they were able to go home rather than being admitted or having to wait.
The emergency department was also able to test for influenza. This had a significant benefit as patients were able to be tested for ‘flu’ quickly. This reduced the use of unnecessary anti-viral medicines, as well as reducing the number of patients being isolated unnecessarily.
And in surgery at St George’s the service had developed an innovative programme called ‘Get Set 4 Surgery’ to help patients prepare for having an operation and understand what would happen at each stage of their journey, from surgical assessment to discharge and recovery at home. The service had been recognised for this innovative practice through an award from Healthy London Partnership.
However, there were areas where the trust must now make improvements:
- Ensuring consent is correctly recorded in patients notes in line with best practice.
- Ensuring all patient records are stored securely, completed accurately and kept confidential.
Areas the trust should take to improve services include in the emergency department:
- Completing all documentation correctly, including fluid balance charts and pain scales.
- Checking that all equipment is clean, safe for use, and appropriate checklists are completed.
- Displaying information about how to raise a concern in all patient areas.
In medical care the trust should:
- Continue work to improve vacancy, sickness and turnover rates amongst nursing staff.
- Reduce the number of patient-moves at night.
In surgery at Queen Mary’s the trust should:
- Ensure senior staff are clear of who has overall responsibility and oversight of surgery at Queen Mary’s Hospital.
- Improve staff awareness on learning from incidents.
Professor Ted Baker, England’s Chief Inspector of Hospitals, said: “There has been significant improvement at St George’s University Hospitals NHS Foundation Trust and I was pleased to see that. However, the trust needs to work hard to improve its overall rating in the future.
“I have recommended to NHS Improvement that the trust is ready to be taken out of special measures, provided some continuing support is still in place.”
CQC has also published the trust’s Use of Resources (UoR) report, which is based on an assessment undertaken by NHS Improvement. The trust has been rated as RI 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 RI.
You can read the inspection report in full when it is published on the CQC website by clicking on www.cqc.org.uk/provider/RJ7
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