The Care Quality Commission (CQC) has rated community sexual health services run by Central London Community Healthcare NHS Trust as good, following an inspection in October and November.
This is the first time CQC has inspected the trust’s sexual health services as a standalone service. The trust provides these services to people across south west London and Hertfordshire.
This inspection was carried out to review improvements the trust had made since a 2021 incident in which a person suffered a perforated bowel due to an incorrectly removed intrauterine device (IUD). During this inspection, inspectors found the trust had made improvements to protect people in future and staff were very aware of learning from that incident.
As well as now being rated good overall, sexual health services have also been rated good for safe, effective, caring, responsive, and well-led.
The overall rating for Central London Community Healthcare NHS Trust remains good.
Jane Ray, CQC deputy director of operations in London, said:
“When we inspected the community sexual health services at the trust, we were very pleased to find staff understood and met people’s needs with compassion and respect. The service had also learned from a previous incident and had taken steps to make sure this didn’t happen again.
“People using the service gave us overwhelmingly positive feedback about the staff, and we saw this reflected in staff’s practice. We saw staff listened to people to understand their individual needs, explained their treatments thoroughly, and respected their decisions as partners in care.
“We saw most leaders supported a culture of continuous learning and development to improve people’s care, and responded well to people’s feedback.
“However, we had some concerns about the culture in their south west London service, which was reflected in what staff told us about the team. The concerns we found included accusations of bullying, racism, and homophobia by leaders towards other staff. Some staff told us they didn’t always feel safe raising concerns about leaders because they feared retribution, which is unacceptable.
“The trust had commissioned an external investigation into discrimination which was due to report in November 2023. The trust’s leadership must tackle these concerns as a priority, as all staff should feel safe and listened to.
“We’ve shared our findings with the provider so they know where they have good practice to build on, and where improvements must be made in the culture and relationship between operational staff and senior leaders at the trust. We’ll continue to monitor the service, including through further inspections, to ensure people continue to receive the high standard of care we found here.”
Inspectors also found:
- Staff had the training they needed to meet people’s needs
- People’s care records were clear and comprehensive
- The service made it easy for people to give feedback and encouraged them to do so
- Leaders had introduced projects to improve people’s access to the service, including a text message advice line and an artificial intelligence chatbot called “Chat to Pat”. The chatbot was intended to help people find sexual health information and book appointments online
- The south west London service were developing clinics for deaf and hard of hearing people, due to open in February 2024
- The Hertfordshire services ran a clinic specifically focused on sexual health and wellbeing in the LGBT+ community.
However:
- Some people said they felt the trust could improve communication around long wait times when attending clinic appointments, and the trust was acting to improve this
- Staff told inspectors they felt senior leadership didn’t consistently engage with them, including around changes to the service.