Local Hospitals "Require Improvement"
Regulator's report slams Imperial College Healthcare NHS Trust
Local hospitals are still struggling to meet A&E waiting time targets as a review into deteriorating hospital services is set to begin.
Hamersmith and Fulham Council says that the latest figures show casualty units fell short of the target to treat 95% of patients in A&E departments within four hours.
December’s figures show failures to meet the target are continuing since the closures of A&Es at Hammersmith and Central Middlesex hospitals in September.
Opponents to the changes say too much pressure is now being put on the remaining A&Es, and that this would get far worse if further services were lost, such as those at Charing Cross Hospital.
Hammersmith & Fulham, Ealing, Hounslow and Brent councils set up the commission following the closures and because of NHS plans to effectively scrap the emergency unit at Charing Cross Hospital.
Official NHS figures show the trusts that run St Mary's, Charing Cross, West Middlesex, Ealing and Northwick Park hospitals have all failed to meet A&E waiting time targets in the past three months.
London North West Healthcare NHS Trust which runs Ealing and Northwick Park Hospitals recorded the worst result in the country in the week before Christmas at 53.7 per cent for emergency units treating the most seriously ill patients. Imperial College Healthcare NHS Trust, which runs St Mary’s, Hammersmith and Charing Cross hospitals, also fared badly with 70.2 per cent. West Middlesex University Hospital NHS Trust was not much better at 75.5.
It will add to evidence to be weighed up by an independent commission chaired by leading barrister Michael Mansfield QC and set up by four local councils in North West London who have been deeply concerned by deteriorating local hospital services. The commission starts work this week and will set dates for oral evidence hearings which are planned to start next month.
Hammersmith & Fulham Council Leader Stephen Cowan said: “These latest figures underline once again the importance of this review.
“The independent review, which is free of vested interests, is vital to assess what local trusts are doing to help ensure a safe and sustainable future for our hospital services. I encourage everyone to have their say at the forthcoming public meetings. The deteriorating state of local A&E services is evidence of just how important this review is for West London.”
In 2013 Michael Mansfield QC chaired the Lewisham People's Commission, an inquiry into the proposals to close services at Lewisham Hospital. He has represented defendants in criminal trials, appeals and inquiries in some of the most controversial legal cases in the country. He represented the family of Jean Charles de Menezes and the families of victims at the Bloody Sunday Inquiry. He chaired an inquiry into the shoot to kill policy in Northern Ireland and has represented many families at inquests, including the Marchioness disaster and the Lockerbie bombing. He also represents the family of Stephen Lawrence.
He will be joined on the commission by Dr Stephen Hirst, a retired GP from Chiswick with extensive local knowledge and John Lister, researcher on the People's Inquiry into London's NHS in 2012 and Senior Lecturer in Journalism at Coventry University.
Written evidence on the impact of the changes should be submitted by Monday 2 February 2015 to Peter Smith, Clerk to the Commission, at Hammersmith & Fulham Council. Submissions should be addressed to him at Room 39, Hammersmith Town Hall, London W6 9JU or sent by email to peter.smith@lbhf.gov.uk. Later submissions will be forwarded to the Commission but may not be given the same attention as those received by the deadline.
Weekly A&E figures supplied by NHS England» (opens new window)
% of patients seen within 4 hours
Week ending 28/12/14
Week ending 21/12/14
Week ending 14/12/14
Week ending 7/12/14
London North West Healthcare NHS Trust (Ealing, Northwick Park)
63.9
53.7
62.6
67.3
West Middlesex University Hospital NHS Trust
78.7
75.5
86.1
83.1
Imperial College Healthcare NHS Trust (St Mary’s, Hammersmith, Charing Cross)
79.3
70.2
72.1
75.7
Chelsea and Westminster Hospital
98.1
96.2
93.5
97.1
% of patients seen within 4 hours
Week ending 30/11/14
Week ending 23/11/14
Week ending 16/11/14
Week ending 9/11/14
London North West Healthcare NHS Trust (Ealing, Northwick Park)
65.7
70.5
68.7
69.2
West Middlesex University Hospital NHS Trust
80.4
88.4
68.7
69.2
Imperial College Healthcare NHS Trust (St Mary’s, Hammersmith, Charing Cross)
79.2
83.0
77.5
85.8
Chelsea and Westminster Hospital
95.2
94.2
95.7
94.6
% of patients seen within 4 hours
Week ending 02/11/14
Week ending 26/10/14
Week ending 19/10/14
Week ending 12/10/14
Week of 05/10/14
London North West Healthcare NHS Trust (Ealing, Northwick Park)
74.6
73.3
67.8
78.1
80.5
West Middlesex University Hospital NHS Trust
88.0
87.4
83.7
91.6
90.6
Imperial College Healthcare NHS Trust (St Mary’s, Hammersmith, Charing Cross)
85.4
86.5
82.5
87.9
83.1
Chelsea and Wesminster Hospital
93.8
96.0
95.1
97.0
97.4
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damning new report by health regulator the Quality Care Commission has rated all three main hospitals run by Imperial College Healthcare NHS Trust - Charing Cross, Hammersmith and St Mary's - as "requires improvement".
Only the maternity hospital Queen Charlotte's & Chelsea Hospital achieved the higher rating of "good", though it also requires improvement in two areas, safety and leadership.
The A&E at St Mary's in Paddington, which is now used by patients from our borough since the A&E at Hammersmith Hospital in Shepherd's Bush was closed in September, was judged particularly harshly with the inspector rating it "inadequate".
Though the inspector found that care in the A&E was generally satisfactory, the report said: " The standards of cleaning and maintenance of some equipment was inadequate. The department had some issues with patient flow because of the A&E department’s physical capacity in relation to the number of patients it could accommodate.
" There was a lack of bed capacity for those who needed admission. We also had some concerns about the leadership in the A&E department and the lack of drive to improve patient experience on this site for the next five years."
By contrast, the A&E at Charing Cross Hospital - which is currently threatened with downgrading to an urgent care centre - was rated "good", with the inspector praising the safe and efficient operation, strong culture of learning and improving and the fact that staff were proud to be working there.
Overall, the report found that Imperial College Healthcare NHS Trust "requires improvement" in three areas - safety, with the inspector noting inconsistencies in cleanliness and infection control and nurse staffing levels; responsiveness, with criticism of waiting times and complaints management and leadership.
However, two areas - effectiveness of its services and patient care - were both judged "good".
You can read the full report here.
Responding to the inspection report, Trust chief executive Dr Tracey Batten says: " While we are disappointed with our overall rating of 'requires improvement', we think the report is extremely constructive. It clearly sets out our challenges while also recognising the positive impact of our work over the past year and highlighting the great care that we already provide.
" We acknowledge that there are a few areas, such as cleanliness in St Mary’s A&E, that have simply not been acceptable and there can be no excuse for that. But we want to assure patients that this is the exception and that we have acted immediately to address the most pressing issues raised. For example, we have already put in extra staff support and refurbished the A&E at St Mary’s Hospital – with new flooring and lighting, more sinks and additional cleaning rotas. The CQC has now re-inspected St Mary’s A&E and has confirmed that the required improvements have been made.
" Overall, the findings show that our major improvement programmes – such as speeding up our recruitment processes, investing in better patient admin and IT systems, making care pathways more patient centred and building staff leadership and engagement – are moving us in the right direction. It’s clear that we now have to redouble our efforts in a number of areas and services.
" The report also shows that there is a lot of great care and clinical practice that we can build on. Most importantly, our staff are consistently seen by patients as caring and compassionate. And we achieve some of the best results for patients, including in our specialist centres for stroke and major trauma, as well as one of the lowest rates of patient deaths in the whole of the country. Our maternity and gynaecology services and our end of life care were rated as good across the whole Trust.
" We have already begun work on an action plan in response to the CQC report, which is due to be submitted in mid January. We hope to work closely over the coming months with our partners and stakeholders, and especially with patients and local communities, to move all of our ratings to good and ultimately to outstanding. Our initial action plan will be presented at our next public Trust Board meeting on Wednesday 28 January 2015."
The report however, does cast yet more doubt on plans for the downgrading of Charing Cross Hospital. Reacting to the CQC’s report, Cllr Stephen Cowan, Leader of Hammersmith & Fulham Council, said: “This is a damning report which backs our view that closing Charing Cross Hospital’s A&E will put lives at risk.
" This comes just a few months after it emerged the Trust had serious financial problems and it raises wider questions about the competency of the people arguing for Charing Cross Hospital to become a much smaller urgent care clinic. We are determined to defend Charing Cross and our local NHS and this report demonstrates just why it’s vital we do that."
December 19, 2014
