University College London Hospitals NHS Foundation Trust

Updated 11 December 2018

University College London Hospitals (UCLH) is a large NHS Foundation Trust situated in central London. The trust provides a range of acute and specialist services across 11 CQC-registered locations. The trust balances the provision of specialist services with acute services for the local populations of Camden, Islington, Westminster, Barnet, Enfield and Haringey. The trust has over 1,000 inpatient beds and employs over 8,800 staff. In 2017/18 the trust saw over 1 million patients with over 137,500 patients visiting the emergency department and 6,700 babies born.

We last inspected the trust in March 2016 and rated the trust good overall.

Updated 11 December 2018

Our rating of the trust stayed the same. We rated it as good because:

• We rated effective, caring and responsive as good, and safe as requires improvement.
• We rated well-led for the trust overall as good.
• We rated 10 of the 11 services inspected as good. In rating the trust, we also took into account the current ratings of the services not inspected this time.
• The trust managed patient safety incidents well. Staff recognised incidents and reported them appropriately. There were systematic and established systems in place for reporting, investigating and sharing learning from incidents and near-misses.
• Staff followed national professional standards and guidelines to achieve the best possible outcomes for patients receiving care and treatment. Audits and quality outcomes were conducted at departmental level to monitor the effectiveness of care and treatment.
• Different groups of staff worked together as a team to benefit patients. Medical staff, nurses, midwives and allied health professionals supported each other and worked collaboratively to deliver effective, patient-centred care.
• Patients and their families were treated and cared for with compassion, patience and respect. Feedback from patients about their experience of care was consistently positive.
• Services were planned and provided in a way that met and supported the needs of local people, including those with complex or additional needs. The trust worked closely with the commissioners, clinical networks, patients and other stakeholders to plan the delivery of care and treatment.
• There was a positive and friendly culture. Staff told us that they were proud to work for the trust and were well supported by their colleagues.
• Managers across the trust promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values. Leaders were knowledgeable about service performance, priorities, as well as challenges and risks.
• There was a strong culture of improvement, research and innovation. There was a commitment to improving services by learning both when things went well and when they went wrong. Safe innovation and team success was celebrated.

However:

• The trust failed to reach key national performance targets for example the 62-day cancer and four-hour ED targets, where performance also fell below the England average.
• BME staff were not well represented in senior positions in the trust. Board members recognised that they had work to do to improve diversity representation across the trust at a senior level.
• The trust did not have a fully collaborative approach with its NHS mental health partner trust to ensure the best patient pathways for patients living with mental health conditions.
• Mandatory training in key skills for medical staff fell below the trust’s target for compliance.
• We observed a number of lapses in good infection prevention and control measures including some staff not following trust procedures and the cleanliness of the environment and equipment in some areas presented an infection control risk.
• Whilst we saw many examples of good practice in relation to medicines management, the trust’s policies for safe storage and management of medicines were not always followed consistently.

Our full Inspection report summarising what we found and the supporting Evidence appendix containing detailed evidence and data about the trust is available on our website – www.cqc.org.uk/provider/RRV/reports.

Updated 11 December 2018

Updated 11 December 2018