University Hospital Lewisham judged “requires improvements” by watchdog

A hospital trust has been rated “requires improvement” by inspectors two years after getting the same rating.

But urgent and emergency care at University Hospital Lewisham (UHL) has improved from “requires improvement” to “good”.

And its management, the Lewisham and Greenwich Hospitals Trust, has achieved an overall rating of “good” for caring.

The Care Quality Commission (CQC) has released the results of its February 2020 inspection into UHL and Queen Elizabeth Hospital in Woolwich.

The CQC found significant improvements across the organisation:

• The CQC improved the ratings of over half the areas they inspected
• Over three quarters of the Trust’s service domains are now rated as “Good” or “Outstanding” (with no areas rated as “Inadequate”

In the CQC’s ratings for the five key areas (safe, effective, responsive, caring and well-led)

•  The Trust’s rating for well-led has improved to ‘Good’
• The Trust’s rating for effective has improved to “Good”
• The Trust retains its rating of “Good” for caring
• The overall rating for the safe and responsive domains remains “Requires Improvement”

Ben Travis, chief executive, said: “We’ve made a number of improvements since the last CQC inspection in 2018, and this report shows that – while we have got more to do – we are on the right track.

“We will continue to focus on getting it right for every patient, every time. This means continuing to support front line staff so we can build on all the good work we’ve carried out over the last few years.

“We’ve also taken immediate actions to address the areas where the CQC noted that we need to improve.”

A CQC spokesman said: “Lewisham and Greenwich NHS Trust has made improvements and CQC recognise that the Trust’s leadership is moving the organisation in the right direction.”

The CQC report noted that:

• Critical care services at Queen Elizabeth Hospital (QEH) achieved a rating of “Outstanding” in the “well-led” domain – an improvement from “Requires Improvement” in the previous inspection
• The education and development programme offered to nurses in urgent and emergency care services at QEH was cited as an example  “outstanding practice”
• Surgery services at both University Hospital Lewisham (UHL) and QEH have improved from “Requires Improvement” to achieve a rating of “Good”
• Critical Care services at QEH have moved from “Requires Improvement” to “Good”
• A number of hospital services were not inspected and retain their rating of “Good”, namely: urgent and emergency services at UHL, critical care at UHL, maternity at both UHL and QEH, children and young people’s services at UHL and outpatients at QEH
• Community services in Lewisham were not inspected and retain their rating of “Outstanding”

The CQC inspection noted that improvements needed to be made at QEH for the safe and secure storage of medicines and for care of patients with mental health needs in urgent and emergency care. In response:

• The Trust’s pharmacy and nursing teams have been engaging with frontline staff to ensure safe and secure medicines management. This has included producing clear guidance for staff on monitoring best practice and escalating any issues to ensure that the Trust meets best practice guidelines
• The Trust has worked with Oxleas NHS Foundation Trust to set up a mental health suite next to the urgent care centre, so that the high number of mental health patients requiring emergency care can be treated in the right environment. Specialist nurses and therapists from Oxleas staff the area, overseen by consultants from the emergency department. The Trust is also currently reviewing all arrangements for patients with mental health needs who receive urgent and emergency care.