The Care Quality Commission (CQC) has published inspection reports on Moorfields Eye Hospital NHS Foundation Trust.
CQC inspected surgery at Moorfields Eye Hospital in September.
It also carried out an inspection of the trust’s leadership in November, due to the link between how well-led a healthcare organisation is and the quality of care it provides to people.
The inspection was triggered by some by incidents, including one which is still under investigation where a patient died, and an IT incident which caused a backlog of referrals.
CQC also received concerns about behaviours of some staff working in operating theatres at Moorfields Eye Hospital which warranted further investigation.
The inspections found several examples of where leadership arrangements were helping staff deliver high-quality care that supported people to enjoy good outcomes.
However, some areas the trust had identified as needing improvement were still in their early stages of development. The trust also has work to do to improve aspects of its culture and internal engagement, to help it ensure it can consistently provide the best possible care.
Ratings for the trust and hospital are unaffected by these inspections; they remain good and outstanding respectively.
Nicola Wise, CQC head of hospital inspection, said:
“Our inspection found the trust’s leaders had a good vision for what they wanted to achieve for people, and they were taking steps towards that – despite significant change at executive level and being in a period of transformation.
“We also found surgery at Moorfields Eye Hospital was accessible to people, without long waits, because the service had enough staff.
“However, there was some uncertainty among staff in surgery about the continuing and sustainability of improvements due to senior people being on interim contracts.
“Some staff also felt more work was needed to improve communication between some staff groups and develop cohesive working relationships to support good patient care.
“Leaders must help staff have the confidence to speak up when they feel they have been treated unfairly, disrespectfully or not in line with the trust’s values because these issues ultimately effect patient care. The trust is taking action to address these cultural issues, and it must continue this work at pace.
“Following the inspection, we reported out findings to the trust’s leaders – so they know where they have work to do. We continue to monitor the trust to ensure people receive safe and effective care and treatment.”
The inspection or the trust’s leadership arrangements found:
- The trust was strengthening the leadership structure for medical and nursing staff.
- The executive leadership team was keen to improve the experience and opportunities for all its staff, and it was committed to delivering high-quality care and treatment.
- The trust was re-establishing and improving how it communicated with its staff.
- The trust had improved its systems to reduce risk when introducing new technology or procedures.
However:
- Some improvement work in Moorfield Eye Hospital’s surgery was still at early stages.
- The freedom to speak up guardian, whose role is to support workers to raise concerns when they feel that they are unable to do so through other routes, was not embedded across all the trust’s sites.
- Work to improve equality, diversity and inclusion had been slow.
- Some staff felt more work was needed to promote an open and transparent culture and more cohesive relationships.
The inspection of surgery at Moorfield’s Eye Hospital found:
- Some improvements had been made, including in leadership and governance, while others were in the process of being implemented.
- Some staff were positive about working in the service, telling inspectors they felt comfortable to raise concerns.
- The service had enough staff to care for patients and keep them safe.
- Staff kept care records, managed service safety incidents well and learned lessons.
- Leaders understood where there were issues, and they were responding appropriately.
However:
- Some staff felt unsupported or unvalued.
- Due to a restructure, not all staff were clear of their accountabilities or their lines of reporting.
- Key policies needed to be reviewed in line with the trust’s timescales.
- There was a lack of clarity about some aspects of managing theatre lists – for example, regarding steps staff would need to take if a theatre list ran over time.