The Care Quality Commission (CQC) carried out a focused inspection of surgery and urgent and emergency services at The Hillingdon Hospital in October. CQC has raised the rating for surgery from requires improvement to good. CQC has again rated urgent and emergency services requires improvement.
CQC inspected to follow up on warning notices it issued to both services in August 2024 due to concerns around safety and management. This inspection found improvements had been made in these areas, though the trust will need to continue this work.
- CQC has upgraded surgery from requires improvement to good for safe. Inspectors again rated it requires improvement for well-led.
- CQC has upgraded urgent and emergency services from inadequate to requires improvement for safe. Inspectors again rated it requires improvement for well-led.
This focused inspection looked specifically at concerns raised in these warning notices, so only examined safety and leadership for each service. Across both services, effective, caring, and responsive retain their ratings from previous inspections.
The Hillingdon Hospital as a whole has been upgraded from inadequate to requires improvement for safety. It remains requires improvement overall.
At both services, inspectors found:
- Leaders had improved people’s safety and the management of the services, though further work was ongoing.
- People’s feedback gathered by the trust had improved for both services.
- Leaders were investigating and acting on safety incidents quickly, to improve people’s care and protect them from repeated mistakes.
In the surgery service, inspectors found:
- Leaders had improved people’s access to beds, washing facilities, and hot food on the surgical assessment unit. The unit was calm and uncluttered.
- The trust had reduced the average time people had to stay on the surgical assessment unit.
In the urgent and emergency services, inspectors found:
- Staff were better triaging children and young people and directing all people faster to the right services, improving flow through the hospital.
- Staff kept the department clean and protected people from risks of infection.
- However, when there are temporary beds shortage due to pressure on the service, some people had to be cared for in temporary escalation etc.
- Leaders lacked data on how long people were staying in temporary escalation spaces. They were working to improve this.
- The trust didn’t always ensure children and young people with mental health conditions in the paediatric emergency department had access to dedicated spaces which reduced the risks of self-harm. Staff needed to stay with them to reduce this risk instead.