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Whipps Cross hospital is inadequate, says CQC

Major problems with staff retention and morale, incident reporting and waiting times

Louise Prime

Wednesday, 18 March 2015

Barts Health NHS Trust is in special measures after the Care Quality Commission rated Whipps Cross University Hospital as ‘inadequate’, it has revealed. The CQC identified a long list of problems at the hospital, relating to staffing levels and morale, patients being cared for in inappropriate places, missed waiting time targets and poor incident reporting, and the chief inspector of hospitals for England, Professor Sir Mike Richards, has again called for improvements at the hospital.

The CQC inspection in November 2014 found that very many services provided by Whipps Cross, in Leytonstone, east London were inadequate – urgent and emergency services, medical care, surgery, end of life care, outpatients and services for children and young people. In addition, its critical care and maternity and gynaecology services were rated as ‘requires improvement’. Immediately afterwards, the chief inspector of hospitals reported his concerns to the provider, Barts Health NHS Trust, and sought urgent action to improve services’ quality and safety. Since then the CQC has issued the Trust with four warning notices requiring it to improve the care and welfare of patients, its system for assessing and monitoring services, staffing levels, and handling of complaints, and CQC inspectors will soon conduct follow-up visits to ensure compliance.

In the CQC’s full inspection report, which it published yesterday, it described:

  • Low staff morale with a culture of bullying and harassment, and some staff reluctant to speak to inspectors in case of repercussions.
  • Not enough nurses or doctors to ensure safe care. A reorganisation of staffing in 2013 had a damaging impact. Staff were overstretched – and there was an atmosphere that did not help in recruiting or retaining permanent staff. Some agency staff had not been trained properly in their roles.
  • Average bed occupancy so high that it was affecting the flow of patients through the hospital, with some admitted to wards inappropriate to their needs. Patients were cared for in recovery areas, others were transferred out of critical care beds, despite their clinical needs. People who were well enough to leave hospital experienced long delays in being discharged because paperwork had not been completed, or because transport was not ready.
  • Persistent failure to meet national waiting time targets, with waits of more than 18 weeks from referral to treatment. Too many operations were cancelled due to a lack of available beds.
  • Staff did not have the time and were not encouraged to report incidents, and were unaware of any improvements or learning. Even senior staff were unaware of serious incidents, and how they should have been involved in leading any required changes.

Professor Sir Mike Richards, said: “Our inspection of Whipps Cross University Hospital has highlighted a number of serious concerns surrounding poor leadership, a culture of bullying, and low staffing which has led to risks to patient safety. I note that many of the failings which we found on inspection in November 2013 are still not resolved. In some areas there has been little progress – and this has been affecting the quality and safety of patient care ...

"Barts Health NHS Trust has not given sufficient priority to safety. We found frequent staff shortages and a reliance on agency and locum staff that increased the risk to patients. The trust must get a grip on what is happening here and on the low staff morale.”

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