West Middlesex 'requires improvement', say inspectors

Accident and emergency, surgery, children and young people services, end of life care, outpatients and diagnostic imaging were all rated as “requires improvement”.

However, medical care, critical care, maternity and gynaecology services were all found to be “good”.

The trust is expecting to merge with Chelsea and Westminster Hospital Foundation Trust later this year.

The “protracted” merger process with Chelsea and Westminster had led to a high use of interim senior managers and “planning blight”.

This had particularly affected surgery with an “unstable management support”. Inspectors found that staffing levels in A&E did not meet the required standard for consultant cover or nursing.

Midwifery staffing levels were also below the required level, “creating an increased risk to patient safety”.

A shortage of surgeon consultants in orthopaedics and general surgery meant there was a lack of consultant involvement in emergency surgery.

Planning and staffing to care for dying patients were “below expected standards” and not “responsive” to people’s needs, the CQC said.

The inspectors also noted the trust did not have an acute oncology service and was therefore “not responding to the needs of acutely medially ill cancer patients”.

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A high number outpatient clinics were also cancelled.

However, the team noted that the trust had a “long term vision” and said the leadership team was experienced and “fully engaged”.

The culture of the trust was considered to be “positive, open and transparent” overall, but the inspectors did receive some reports of what some staff considered to be a “blame culture”.

Trust chief executive Jacqueline Totterdell, who joined in March, said: “First and foremost we want people to receive the best care possible, so that everyone who uses our services feels personally supported and involved in their treatment. I am delighted that the hard work and efforts of our staff have been recognised by the CQC, and that patients and relatives have given such great feedback about their experiences here.

“Despite our obvious strengths and caring attitudes of staff, there are some areas requiring improvement. The report made clear the issues we must focus on and we have been working collaboratively with our health and social care colleagues to address some of these.”

Chief inspector of hospitals Sir Mike Richards, said: “When we inspected West Middlesex University Hospital Trust we found that, while staff were caring and compassionate – and some were going the extra mile for patients, some of the services we looked at required improvement.

“Our overall findings highlight the level of variation that can be found within the same organisation. There are a number of areas of good practice in the trust and we hope that the trust can quickly build on this and consistently deliver good services across the board.

“Staffing will remain an issue while the trust is going through this period of transition and the leadership needs to manage this and not divert from their action plan.”