PERFORMANCE: A respected London teaching hospital has been told it ‘requires improvement’ by the Care Quality Commission.

The watchdog issued the directive today after its inspectors pinpointed problems in a range of services provided by Chelsea and Westminster Hospital Foundation Trust’s during an inspection in July.

The FT’s accident and emergency department, surgery, children and young people’s services, end of life care and outpatient services all require improvement, inspectors’ concluded in their report.

In contrast, its HIV and sexual health services were rated “outstanding” and its maternity and critical care as “good”.

Inspectors said the hospital’s A&E was struggling to cope with demand, and patients waited a long time for surgery, particularly for trauma, orthopaedics, urology and plastic surgery.

They also raised concerns over the leadership of the trust.

The report said: “Staff felt the chief executive was visible but this was not the same for other members of the board.”

Inspectors said serious untoward incidents took “a long time” to investigate, and only 36 per cent were looked into within the 45 day target.

Staff in a few areas highlighted a “blame culture” when reporting these incidents.

The trust also relied too heavily on agency staff who “did not always have a good induction” to the surgical department.

Equipment was not checked regularly, and the storage of medicines could be improved in some areas.

Mortality rates were found to be lower than the “expected range”, while waiting times for surgery were longer than national averages.

The majority of staff described the trust as a “good, friendly place to work”. However, in neonatal care staff reported a “bullying culture”.

A&E staff said there was “low morale”.

Support for patients with a learning disability or dementia could be “excellent” but was “inconsistent”.

The inspection team credited the burns unit as “internationally recognised” and noted that the female genital mutilation service had been given a national award for innovation and care.

Sexual health services were found to be “outstanding” with outreach clinics held at local gay bars, and the trust had employed two patient representatives on a part time basis to obtain views of the service.

There were issues with the IT system, which staff said dated back to 1979. The trust said it was planning to replace this system.  

The trust hopes to take over West Middlesex University Hospital Trust and the proposed merger is currently being assessed by the Competition and Markets Authority.

CQC chief inspector of hospitals Sir Mike Richards said: “Our overall findings highlight the level of variation that can be found within the same organisation.

“We hope that the trust can quickly build on the good work that we found in most areas to consistently deliver good services across the board.

“People are entitled to receive treatment and care in services which are safe, effective, caring and responsive to their needs. We’ll return in due course to check that the improvements needed have been made.”

Trust chief executive Tony Bell said: “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.

“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.”