Since the Care Quality Commission (CQC) inspection and report in 2020, the health care services provided by Hillingdon Hospital NHS Foundation Trust have been rated as “Inadequate”. The Trust has undergone subsequent inspections, which have continued to identify areas of concern and this remains the case following the most recent CQC inspection in May 2021.
Hillingdon Hospitals NHS Foundation Trust provides services from both Hillingdon Hospital and Mount Vernon Hospital. The Trust has approximately 3,300 staff and provide healthcare for the residents of the London Borough of Hillingdon and increasingly to residents of Ealing, Harrow, Buckinghamshire and Hertfordshire. The catchment area is estimated to be in excess of 350,000 people.
Hillingdon Hospital is an acute and specialist health care services provider with the only acute hospital in Hillingdon with a busy Accident and Emergency, inpatients, day surgery, and outpatient clinics.
Are the services at Hillingdon Hospital NHS Foundation Trust safe?
Since the CQC inspection in 2018, the rating for the safety of services was reduced to “Inadequate” and retains this status following the most recent inspection in 2021.
The 2018 inspection identified the following areas of concern with regards to safety:
- There was deterioration in infection prevention and control since the time of the last inspection. We found inconsistencies in hand hygiene practice amongst staff, during ward rounds.
- Medicines were not always appropriately stored or checked in the ED.
- There was poor recognition of sepsis.
- There had been some improvement to safe levels of staffing. However some services within the Trust did not have enough permanent nursing and medical staff to ensure the provision of safe care and treatment.
- There were out of date copies of the major incident plan on some wards and this was against the trust’s own policy.
- The Trust had not improved in relation to the testing of portable electrical equipment. Not all portable appliances had been tested.
- It was not clear that all high-risk patient groups were screened for MRSA at pre-admission.
- Staff did not always maintain appropriate records of patients’ care and treatment. Records were not always clear, up-to-date and available to all staff providing care.
- It was not certain that the laser service met the Medicines and Healthcare Products Regulatory Agency safety standards.
The report identified numerous areas for improvement across the emergency services, medical care, surgery, critical care and maternity care.
The impact of Covid 19
It is widely acknowledged that Covid 19 placed extreme pressures on the health service across the country especially at the peak of the pandemic in 2020. Hillingdon Hospital suffered more than most hospitals with a serious outbreak of Covid 19 in July 2020 resulting in many staff having to self-isolate and high numbers of inpatients with Covid-19. As a result of this serious outbreak, the CQC undertook a focused inspection at Hillingdon Hospital in August 2020, which identified significant concerns over the hospitals infection prevention and control measures.
Care Quality Commission Concerns with Hillingdon Hospital’s Infection Control
The inspection in August 2020 noted that there were problems with social distancing between staff and patients in general areas, entrances and corridors. There was a general lack of signage referring to Covid-19 awareness. Lifts did not have signs limiting numbers and inpatients were allowed to congregate in numbers in general areas without challenge by staff.
The CQC took action by issuing Notice of Decision to impose conditions on Hillingdon Hospitals NHS Foundation Trust. This required the Trust to provide assurances to implement an effective system to manage risks to the health and safety of patients, staff and visitors.
The CQC inspected Hillingdon Hospital again on 29 and 30 September 2020 to follow up on the issues that had identified in the August inspection. As a result of this inspection, the CQC was required to take regulatory enforcement action against Hillingdon Hospitals NHS Foundation Trust by issuing a Warning Notice under section 29A of the Health and Social Care Act 2008.
This warning notice identified three main areas of concern, which required significant improvement:
- There was a lack of governance arrangements in place for respirator masks to ensure good maintenance and filter change requirements were met.
- Senior leaders did not always identify risks around infection, prevention and control in medical care areas.
- The Trust did not have an effective system in place to ensure that staff on the medical wards received guidance and support in relation to infection prevention and control issues.
Following a further inspection on 19 May 2021 to follow up and assess the progress that the Trust had made since the issuing of the Warning Notice in September 2020, the Care Quality Commission has published their latest report on Hillingdon Hospitals NHS Foundation Trust dated 21 July 2021.
The focus of the May 2021 inspection was to look at areas relating to infection, prevention and control following the concerns identified in 2020. Reassuringly, a number of improvements have been made in the intervening period, including the introduction of mandatory training for infection control, the introduction of clear signage, improvement in the following of infection control measures and the availability of hand sanitising gel at all entrance and exit points.
However, there were still areas of concern. It was found that the percentage of medical staff that had received infection, prevention and control training was below Trust targets, there were still ventilation problems in the acute medical unit and information was not readily available for patients in relation to Covid 19.
The latest areas of improvement for Hillingdon Hospital were identified as follows:
- Provide COVID-19 information leaflets available in other languages and easy read formats for patients to explain what a COVID-19 swab test is and how it would be taken.
- Make sure all risks identified within the medical care division are documented on the risk register with mitigations in place.
- Ensure the IPC team continue to strengthen initiatives and messaging to promote awareness of significant IPC calendar events.
- Ensure ward staff know how to use and communicate infection prevention and control audit findings from trust systems
Contact our clinical negligence experts.
IBB Law are representing many clients who have suffered avoidable harm while in the care of Hillingdon Hospital NHS Foundation Trust. Our specialist lawyers have considerable experience to help and advise on all types of compensation claims, including those arising from clinical negligence. We offer a free initial consultation so we can get a clear understanding of your situation and give a realistic assessment on your prospects of bringing a compensation claim.
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