Whipps Cross University Hospital rated Inadequate by CQC

England’s Chief Inspector of Hospitals has again rated Whipps Cross University Hospital in east London as Inadequate overall after a comprehensive inspection by the Care Quality Commission in July and August 2016.

Whipps Cross was rated Inadequate for being responsive and well-led. It was rated Requires Improvement for being safe, effective and caring.

Eight core services at Whipps Cross were inspected. Surgery and outpatients and diagnostic imaging were rated as Inadequate. Urgent and emergency services, medical care (including older people’s care), critical care and end of life care were all rated as Requires Improvement. Maternity and gynaecology and services for young people and children were rated as Good. A full report of the inspection has been published on this website.

Whipps Cross University Hospital in Waltham Forest is part of Barts Health NHS Trust, the largest NHS trust in the country, serving 2.5 million people across Tower Hamlets and surrounding areas of the City of London and East London.

CQC inspectors returned to inspect the hospital to follow up on previous inspections of Barts Health NHS Trust in 2014 and 2015 which had identified a number of concerns around patient safety and the quality of care.

As a result of that inspection Barts Health NHS Trust was placed in to special measures. NHS Improvement has been working with the trust to support improvement and there were significant changes made to the leadership of the organisation at both an executive and site level.

Professor Sir Mike Richards, Chief Inspector of Hospitals, said: “Overall, we have rated the service provided by Whipps Cross as Inadequate. In particular surgery was rated Inadequate because of concerns around safety, responsiveness and leadership. Quite clearly the trust must now focus on these areas as a priority. 

“In the past year there have been some big changes in the management at Whipps Cross and the hospital is moving in the right direction.

“Since our last inspection we have noted tangible improvements in safety and effectiveness.  We did find important improvements had been made in maternity and gynaecology and services for young people.

But there is still a long way to go and CQC will be closely monitoring the hospital’s progress to make sure the quality of care there improves for all patients.”

The inspectors found that changes to the leadership structure of the trust and the hospital management were beginning to make a positive impact on standards but the pace was too slow. Most staff spoke optimistically of the new leadership structure, although there were pockets of poor culture with evidence of bullying and inequality.

There was no dedicated place of safety room in the emergency department for patients with psychiatric conditions.

The trust did not provide all patients with one-to-one care during labour which is recommended by the Department of Health.

Inspectors found many examples of a lack of compassion towards patients nearing the end of their lives. Some patients were visibly in pain, but staff did not respond to this by providing them with adequate pain killers.

Emergency department performance against the national four hour target for treatment and discharge was well below the national 95% target..

Actions the trust must now take include:

The report identifies a number of areas for improvement:

• The trust must improve bed management, theatre management and discharge arrangements to facilitate a more effective flow of patients across the hospital.
• The trust must work towards improving the organisational culture to reduce instances of unprofessional behaviour and bullying and ensure all staff feel sufficiently supported by their managers.
• It must ensure that patients' pain levels are monitored and acted on appropriately and that pain relief is provided to patients when required.
• The trust must ensure staff have the skills they need to identify record, escalate and mitigate identified health and safety risks. This should include the recognition and management of the deteriorating patient.

Ends

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