Shock as Chelsea and Westminster is Told It "Requires Improvement"

NHS Trust confident that key recommendations "can be actioned quickly"

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The Care Quality Commission, in its first announced inspection of Chelsea and Westminster Hospital under a new monitoring regime, has given the Chelsea and Westminster an overall rating of "requires improvement".

In fact, the commission - the independent regulator of health and social care in England - found that nine areas out of a total of 13 required improvement.

Out of five inspection areas, the categories Safe, Effective, Responsive and Well-led were all judged requiring improvement, though Caring was judged good.

The checks on specific services were also critical with Urgent and Emergency Services (A&E); Medical care (including older people's care); Surgery; Services for children and young people; End of life care and Outpatients all requiring improvement.

However, Intensive/critical care and Maternity and gynaecology were judged good and HIV and sexual health services rated outstanding.

The report, based on inspection carried out in July this year comes as a shock as previous inspections, including a surprise visit carried out in September last year, have praised the Fulham Road hospital. You can read this report here.

The Chelsea and Westminster Hospital NHS Foundation Trust has responded to the report by saying it is confident that the CQC’s key recommendations can be actioned quickly.

Tony Bell, Chief Executive, says: " The Trust welcomes the CQC Quality Report and supports any detailed analysis of its services which highlights what we are doing well and where we can do better for our patients and I would like to thank all staff for delivering care during what was an intensive inspection.

"This was the Trust’s first inspection under the CQC’s new approach and we appreciated the opportunity both to illustrate some outstanding practice and to learn from their findings.

" We are obviously disappointed that we have been rated as requiring improvement and take all of their feedback on board. I believe that the areas in which the CQC have said we must make improvements can be resolved swiftly.

“We look forward to working with our commissioners and stakeholders in addressing some of the out of hospital issues that inevitably have an impact on the quality of patient and staff experience at the Trust so that we can drive our ratings to the standards that we believe an organisation like Chelsea and Westminster can deliver to the communities it serves.”

The Trust points out that the findings of the CQC inspection highlight 13 areas of excellence including:

  • Research activity that has actively improved care for patients in service areas including A&E, physiotherapy and burns
  • Nationally recognised female genital mutilation service
  • Staff being actively involved in quality initiatives to improve the care they provide to their patients
  • The neonatal palliative care team having developed standards on caring for very young babies with life limiting conditions who need palliative or end of life care on neonatal units, which have been shared with medical royal colleges and other hospitals for national use

However, it admits some of the CQC’s review shows a need for improvement and consistency in themes including:

  • Risks and pressures around managing demand, staffing and improving safety processes
  • More support for dementia care and learning disability
  • Better governance arrangements

The Trust says it has already been taking action on feedback outlined in the report including agency staff having access to IT patient records and care plans, robust medicines management led by matrons and supported by pharmacy, improving access to a specific area of outpatients highlighted in the report and recruiting 85 permanent nurses and midwives since July.

It is also investing in a multi-million pound scheme to refurbish and extend the emergency department. This will mean more space, more staff and more state of the art equipment to treat patients in an emergency.

Staff were viewed as being caring and compassionate, treating patients with dignity and respect, which was supported by patients who said their experience of care at the hospital was good. Every service reviewed during the inspection was given a caring rating of "good".

The Trust also says the CQC recognised that there were no areas of inadequate care.

Elizabeth McManus, Chief Nurse and Director of Quality, says: " I am sure that people using any of our services will be pleased to hear that the caring nature of our services are viewed by the CQC inspectors and patients as good.

" We can and will keep improving services for patients. We fully take on board the CQC’s feedback on the areas in which we need to make improvements and have already actioned some of the areas highlighted in the report. 

"We are involving staff in developing our action plan to address each recommendation as we want to be good or outstanding across the board in our next inspection."

October 29, 2014