Huge hospital trust leaves special measures after four years

Inspectors from the Care Quality Commission visited Barts Health Trust in September and October last year, finding improvements in three of its five measures.

But the watchdog also highlighted concerns over bullying at Whipps Cross A&E department and it rated Newham hospital’s maternity service as “inadequate” overall for a range of safety concerns, issuing a warning notice to the trust following its inspection.

Overall Barts Health was rated “good” in effective, caring and well-led, although it is still rated “requires improvement” in safety and responsive. The CQC recommended the trust be removed from special measures, which NHS Improvement has accepted. 

Barts provides care across five sites in east London and accounts for 1.5 per cent of hospital activity in England, according to the CQC.

However, the £1.5bn turnover trust remains in financial special measures. The CQC said Barts is on track to deliver an underlying deficit of £138.3m, a marginal improvement on £139.8m in 2017-18.

The CQC issued a warning notice to the trust amid concerns about Newham’s maternity unit where staff sought out inspectors to complain of “cliques, favouritism and passive bullying, and a perception of unwillingness to listen to staff concerns and investigate them properly”.

Concerns around safety and governance at the unit, which were raised in a 2015 inspection, had not been addressed and staff told inspectors equipment checks were often cursory and not carried out daily, “in line with policy”. The CQC said it “had concerns about infection control, including the cleanliness of clinical equipment”, while inspectors were worried about waste segregation, noting overflowing sharps bins.

The maternity unit delivers 6,500 babies a year.

A follow-up inspection in mid-January this year found that “staff had made immediate improvements to the main concerns” but that “these areas would need sustained focus”.

Bullying was also raised as an issue at the trust’s Whipps Cross site. The CQC commended the hospital management for making improvements in areas previous inspections had raised as concerning, including “significantly improved standards of care, dignity and privacy in medical care”.

But the CQC said there were areas still to improve on, including “pockets of bullying in the emergency department, which the leadership team did not have oversight of”.

Ted Baker, chief inspector of hospitals, said: “In November 2015, CQC rated the trust as ‘inadequate’ overall because of concerns relating to safety, the organisational culture and governance throughout the organisation…

“In many areas the quality of service has been transformed. Credit must go to the leadership team at the trust and to the commitment and hard work of all the staff.”

But Professor Baker added: “There are still areas that require attention, particularly maternity services at Newham. We will return later this year to check that the improvements we have required have taken place.”

The trust’s chief executive Alwen Williams said: “Today is a significant step forward on our improvement journey and a tribute to the skill and dedication of our 17,000 hard working and talented staff. We are grateful for the support our regulators have given us in recent years.

“We will continue to address areas where there is further work to be done, and now look forward to charting our own course to becoming a high-performing group of hospitals, renowned for excellence and innovation, and providing safe and compassionate care to the people of east London and beyond.”