King’s College Hospital NHS Foundation Trust was rated Requires Improvement (RI) overall by the health regulator, Care Quality Commission. It was rated Good for being effective and caring. It was rated RI for being safe, responsive and well-led, following the inspection during September and October 2017.
CQC inspectors did though find some areas of Outstanding practice at the trust. These included:
• The iMobile outreach service was innovative and proactive. There was evidence it was producing positive outcomes for patients and the service.
• There was a robust and well-tested major incident plan in place. The ‘SafetyNet’ communication was recognised as being a rapid means of providing staff with essential information arising from adverse events.
• The trust had set up a ‘Tea Club’ for patients living with dementia needs.
CQC found improvements had been made in a number of areas throughout the trust, although there was work still to be done to bring some of the ratings up. In particular inspectors noted the significant work already carried out and continuing as a means of developing a well-led service.
CQC found the medicine services at King’s College Hospital (KCH) improved the previous rating of Requires Improvement up to Good for safety. All other domains in medicine were rated as previously, which was Good.
Surgical services at KCH were rated as follows: Requires Improvement for responsive, which was unchanged from previous ratings. Effective reduced its previous rating from Good to Requires Improvement. Safe, caring and well-led were rated as Good, the latter being an improvement from the previous rating.
Critical care services improved its ratings up to Good for responsive and well-led and remained as Good for effective and caring. Safety was rated as Requires Improvement, unchanged from the previous inspection.
Action the trust should take to improve At King’s College Hospital include:
Medical service staff needed to complete resuscitation trolley checks on a daily basis. Staff working in medical wards needed to complete fridge temperature checks daily and report abnormal results to facilities and pharmacy in a timely way.
The correct procedure for managing electronic patient records and other confidential information should be reinforced. Improve agency staffs ability to access the electronic patient record system so they can access patient notes in a timely way.
Mental health staff supporting surgical services should be able to access Electronic Patient Records in order to add their notes in a timely manner.
Surgical service should improve the average length of stay for general surgery non-elective patients. The trust should improve the average length of stay for urology non-elective surgical patients The surgical service should improve vacancy rate for nursing and midwifery staff.
The fracture clinic should offer patients privacy and dignity and offer a child friendly environment.
The executive team and clinical director should consider how they can increase their visibility to outpatients’ staff.
At Princess Royal University Hospital (PRUH) outpatient department, the trust needs to ensure that patient records are stored safely and in a manner which prevents unauthorised access. Prescription pads must be stored safely and managed in accordance with best practice.
However, a number of ratings had improved at the PRUH. Of particular note was the work done in the urgent and emergency care to bring the rating up from Inadequate to Good for being responsive. This service also improved the rating from RI up to Good for being effective. All other domains remained unchanged, with RI for safety and well-led and Good for caring.
Professor Ted Baker, England’s Chief Inspector of Hospitals said: “King’s College Hospital NHS Trust was highly praised for the way its staff cared for people caught up in the terrorist attacks that took place in London last year. Staff there also cared for some of those injured at the Grenfell Tower fire.
“The demands on the trust are high and by and large it copes satisfactorily and is moving in the right direction – though it needs to do more. It is disappointing that the trust is still Requires Improvement overall.
“While the trust has made some improvements, it needs to increase the pace of improvement and should use our report to drive the further improvement needed.”
You can read all the reports relating to this inspection in full by visiting www.cqc.org.uk/provider/RJZ/reports
when they are published on CQC’s website.