University College London Hospitals NHS Foundation Trust has been rated Good overall by the Care Quality Commission.
The trust was rated Good for being effective, caring, responsive and well-led. It was rated Requires Improvement for being safe, following the inspection which took place between the end of July and mid-September 2018.
CQC inspected 11 services across three of the trust’s locations. At University College Hospital and Elizabeth Garrett Anderson Wing, urgent and emergency care, medical care, outpatients, maternity and gynaecology services were inspected. CQC re-inspected these services to check that the trust had acted to address areas that required improvement. At the National Hospital for Neurology and Neurosurgery (NHNN) CQC inspected surgery, medical care, outpatients and critical care services. This was because they had not been inspected under CQC’s new methodology. At the Sir William Gower Centre medical care and out-patients’ services were inspected for the same reason.
Inspectors found that the trust managed patient safety incidents well. Staff followed national professional guidelines to achieve the best possible outcomes for patients.
Nurses, midwives and allied health professionals supported each other and worked collaboratively to deliver effective, patient-centred care. Patients and their families were treated and cared for with compassion, patience and respect. Feedback from patients about their experience of care was consistently positive.
There was a positive and friendly culture and staff said they were proud to work for the trust and felt well supported by colleagues.
CQC also found some areas of outstanding practice. These included in the maternity service online skype clinics, fetal surgery for spina bifida and an integrated ‘one stop’ service providing an efficient diagnosis and treatment facility.
At the National Hospital for Neurology and Neurosurgery numerous research projects were taking place and a high proportion of patients were involved in clinical trials. The hospital had an award to study the use of neuroimaging to facilitate the effect of deep brain stimulation to improve motor symptoms of Parkinson’s disease.
The trust ran a treatment for stroke that removes the clot blocking the artery within the brain, restoring blood flow and minimising brain tissue damage. The hospital’s Huntington’s disease service provided a world leading research programme as well as clinical services including investigations and diagnosis, predictive and prenatal counselling, testing, symptom management, psychosocial support, information and advice service to patients and their families. The Sir William Gower Centre was at the forefront of epilepsy research and had a large programme of research including genetics.
However, the trust failed to reach key national performance targets for example the 62-day cancer and four-hour ED targets, where performance also fell below the England average.
BME staff were not well represented in senior positions in the trust. Board members recognised that they had work to do to improve diversity representation across the trust at a senior level.
Mandatory training in key skills for medical staff fell below the trust’s target for compliance.
Inspectors observed a number of lapses in good infection prevention and control measures including some staff not following trust procedures and the cleanliness of the environment and equipment in some areas presented an infection control risk.
Whilst CQC saw many examples of good practice in relation to medicines management, the trust’s policies for safe storage and management of medicines were not always followed consistently.
Professor Ted Baker, CQC’s Chief inspector of Hospitals said: “The standard of care provided by University College London Hospitals NHS Foundation Trust is good – and we found some outstanding care, especially in maternity care and research at the National Hospital for Neurology and Neurosurgery.
“There are though areas where the trust can still improve and I would like to see the rating for services being safe to move forward from Requires Improvement in the future.”
The CQC has also published the trust’s Use of Resources report, which is based on an assessment undertaken by NHS Improvement. Various factors are considered by NHSI, including a combination of data on the trust’s financial performance over the previous 12 months, NHS Improvement’s local intelligence and the trust’s assessment of its performance. As a result of this review the trust has been rated as ‘Good’ for use of its resources. The combined rating for both quality and use of resourced is also ‘Good’.
You can see the latest ratings tables for the trust on pages 14, 15, 16 and 17 of the inspection report. You can read the report in full when it appears on CQC’s website by clicking on this link: www.cqc.org.uk/provider/RRV
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