Central Middlesex Hospital rated Good in latest CQC inspection report
The Care Quality Commission (CQC) has rated both Central Middlesex Hospital (CMH) and its urgent and emergency care services as ‘Good’, following an inspection of urgent and emergency care services across LNWH in July this year.
Inspectors highlighted an open and honest culture, good communication skills and a high level of clinical care among staff, with leaders in the service described as inclusive, skilled and credible.
Patients described staff as “caring and considerate”, with teams respecting their cultural and religious needs. Inspectors observed staff across all three hospitals treating patients with kindness, compassion and respect, and found that they involved patients in their care.
Urgent and emergency care services at Ealing and Northwick Park improved their rating for ‘effective’ – one of five domains tested by the CQC – to ‘Good.’
Inspectors also praised a new sepsis room at Northwick Park, allowing staff to give intravenous antibiotics more quickly, and significant improvements to emergency sickle cell care.
Areas that require improvement are centred around long waits and care provided in temporary escalation spaces – although inspectors recognised the pressure on teams, with Northwick Park A&E regularly receiving the highest number of blue light ambulances in the UK, and unprecedented attendances at both sites.
At peak times, both hospitals do not have enough physical space to accommodate patients in designated areas, so that some patients receive care in additional areas known as temporary escalation spaces. The Trust has improved procedures to make it clear that these patients will always remain in sight of clinical staff, with a ratio of one nurse caring for no more than five patients. The change will not only improve patient safety but will offer better support to patients and their loved ones.
Meanwhile, new private spaces for examinations and discussions will offer greater confidentiality, privacy and dignity for patients receiving care in these areas.
To reduce the need for temporary escalation spaces, the Trust’s Clinical Decision Unit has increased its capacity to improve waiting times, while a new discharge ready unit supports patients ready to leave hospital but awaiting social care, and a new Older People’s Short Stay Unit provides specialist care to elderly patients earlier in their stay.
The report also notes that there is more work to do at Ealing Hospital to improve infection prevention and control processes. The Trust has introduced daily hand hygiene audits and weekly spot checks to ensure teams are compliant and is working to improve procedures for isolating patients with contagious illnesses, with a ‘front door’ check where new patients are asked additional questions about any potential infection risk.
Chief Executive Pippa Nightingale said: “We are extremely proud that both Central Middlesex Hospital and its urgent care service are now rated Good.
“We’re also delighted that inspectors recognised that the service across all three hospitals has such a strong, supportive, and safety-focussed culture, and that they praised the compassionate and high-quality care provided by our teams.
“It’s a tribute to our teams that they have been able to make such impressive improvements in the face of unprecedented pressure on our emergency departments.
“We know this pressure means that we must do even more this year to keep patients safe. I’m confident that the actions we’ve taken will further improve the safety and experience of people who need emergency care.”
New initiatives started since the inspection include a major wayfinding project to review and replace directional signage, plans to develop a new paediatric waiting room at Ealing, and work to introduce hearing loop technology.
The reports will be published on CQC's website shortly: