Surgery at Whipps Cross is better - but still Requires Improvement says CQC

Surgery at Whipps Cross University Hospital has improved but still Requires Improvement according to the Care Quality Commission.

CQC inspectors revisited the surgery department at the hospital in Leytonstone, East London, in April 2018. Part of Barts Health NHS Trust, surgery was rated Inadequate when it was previously inspected in 2017, when CQC found a number of concerns around patient safety and the quality of care. This most recent inspection was unannounced and focused to ensure the trust had made improvements.

Inspectors found that there had been some improvements to make services safer and more responsive to patients’ needs and this has been reflected in the overall change in the rating from Inadequate to Requires Improvement. However, inspectors also found that some of the concerns highlighted during the previous inspection still needed to be addressed.

CQC’s key findings included:

Medicines were not always being safely managed. Access to medicines, including controlled drugs was not appropriately restricted on the surgical wards and the trust’s medicines management policy was not being followed in relation to medicines storage. CQC found expired medicines were in stock on all surgical wards visited.

Nursing vacancy rates remained high and most surgical wards remained heavily dependent on temporary staff. There were not always sufficient staff to provide appropriate care to patients requiring additional support, for example those living with dementia.

The service performed significantly worse than the trust average in a number of areas in the NHS staff survey.

The trust must now ensure that there are appropriate systems of medicines management at ward level and that staff are aware of their responsibilities in relation to this.

The trust should also:

• Ensure that patients’ care records are accurate, complete, legible, up-to-date and stored securely.
• Ensure that consent to procedures is taken in line with trust policies and best practice.
• Ensure staff have access to reliable equipment, which does not represent a risk to patient safety or delays treatment.
• Ensure there is an agreed replacement programme for theatre equipment.
• Ensure the facilities used by the pain service are fit for purpose.
• Ensure all ward and theatres maintained in a good state of repair.
• Ensure equipment is stored safely and securely.
• Improve referral to treatment time performance and reporting.
• Ensure there are adequate numbers of qualified, skilled and experienced staff employed and used to meet the needs of patients.

However, the leadership team had developed a comprehensive action plan to address the concerns highlighted at the last inspection. CQC saw evidence of some improvements to the surgical service to make it safer for patients and more responsive to their needs.

Staff knowledge about the incident reporting system had improved. Most concerns relating to infection control in the theatre environment had been addressed. Staff compliance with mandatory training including safeguarding training had improved. Staff appraisal rates had improved and now exceeded the trust’s 90% target.

Surgical site infection (SSI) monitoring and follow up post-discharge was now taking place. Recovery areas were no longer being regularly used to nurse patients overnight.

Professor Ted Baker, England’s Chief Inspector of Hospitals said:

“There is still much to do at Whipps Cross University Hospital’s surgery unit. However, there has been some improvement in its rating and I look forward to further improvements in the future.”

Read the report in full

Ends

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