The Care Quality Commission has carried out focused inspections at the two emergency departments (EDs) that are part of King’s College Hospital Foundation Trust.
At King’s College Hospital, Denmark Hill, Camberwell, the ED was rated Requires Improvement. At Princess Royal University Hospital (PRUH) in the London borough of Bromley, the ED was rated Inadequate, following the inspections in November 2019. The rating of the trust overall is not affected and remains at Requires Improvement.
The purpose of these two inspections was to follow-up on concerns from CQC’s previous inspection, conducted in January and February 2019. The concerns focused on patient care and outcomes, culture, governance and leadership. This latest focused inspection was undertaken to review the progress the trust had made.
At the PRUH, CQC had found the emergency department had significant challenges and was previously rated inadequate. This focused inspection was undertaken to review the progress the trust had made.
The department had been going through significant challenge at the time of the first inspection. The local governance and leadership were weak and were being revised to work to improve the service. Culture was poor and there was a level of disharmony within the department and with those of other departments and the local leadership. At the time morale was very low.
Our rating of this service stayed the same at Inadequate. Inspectors found:
- Patients were still experiencing delays in their care due to poor patient flow across both the department and wider hospital. Morale across the department remained low and with that the culture of learned helplessness within the department remained. There was still a disparity in the thinking of the department leadership and the senior divisional leaders with regards to support to the department. The ‘done too’ culture remained within the department.
- Staff still did not always adhere to best practice when storing medicines. Some staff still displayed an apathy towards patients and visitors.
- Inspectors found that improvements had taken place at King’s College Hospital ED. However, there were more improvements to be made and sustained, including:
- The service still did not have fully suitable premises. There was no dedicated paediatric mental health assessment room available and there was a lack of consideration given to ligature points. However, building work was scheduled to address the mental health assessment room.
- Patients could not access care and treatment in a timely way, however, there was evidence of improvement in this area.
Dr Nigel Acheson, Deputy Chief Inspector of Hospitals, said: “It is disappointing that King’s College Hospital NHS Foundation Trust still has much to do to improve standards of care in its two emergency departments.
“There were some moves towards improving care and some more in the pipeline. CQC will be keeping a watchful eye on the emergency departments at both King’s and the PRUH, to ensure future care gets better.”
You can read the reports in full when they are published on CQC’s website at: www.cqc.org.uk/provider/RJZ
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