St Helier is a hospital in crisis

Geoff Martin

The announcement that the trust's long standing chief executive Dr Nigel Sewell was to take early retirement came just days before the release of the CHI report.

The report said hygiene levels at the trust's hospitals must be improved. Patients complained of filthy wards, and in some there was a strong smell of urine.

Complaints

Jennifer Denning said lessons would be learn

It was highly critical of a complaints system under which staff did not feel safe to raise concerns with management.

And it said that while the trust had a strategy for managing risks, was not widely known about or understood.

The recording of incidents or near misses was poor, and staff were unclear which incidents to record.

The trust was formed from the merger of two smaller trusts, and the report says that the two sites do not communicate with each other, creating two sets of patient information.

It was also critical of the leadership of the trust.

It said: "The management of the trust is defensive in its attitude and staff morale is low as communication systems between the executive team and staff are weak."

Death rates

The St Helier Hospital was singled out for particular criticism.

We know there is a lot to do in getting the trust up to the standards we call want

Jennifer Denning

The report found death rates for patients undergoing emergency surgery were higher than for any comparable hospital in England.

Although outpatient waiting times for the trust were lower than the national average, the proportion of patients kept waiting for admission to hospital was higher.

Trolley waits could last up to 20 hours, the Commission investigators were told.

At Epsom Hospital, hospital patients were discharged prematurely due to a lack of nursing staff and beds.

In total, the CHI report made 25 key recommendations for action at the trust.

Serious commitment

Peter Homa, CHI chief executive, said: "The report recognises that Epsom and St Helier needs to make a serious commitment to improving its clinical governance arrangements.

"The trust is currently forming an action plan in response to our report and this plan must demonstrate clearly what steps will be taken to improve patient care."

Trust chairman Jennifer Denning said: "We know there is a lot to do in getting the trust up to the standards we call want, but there is a strong determination among the staff to get things moving quickly."

Geoff Martin, London convenor for the health service union Unison, called for greater investment in the trust.

He said: "The CHI report confirms that St Helier is a hospital in crisis, locked into a spiral of decline with devastating consequences for patient care"

CHI inspectors spent seven months examining services provided by the trust.

They focused on three types of patients, the elderly, those admitted to critical or intensive care for chest and respiratory problems and those requiring treatment for an aortic aneurysm.

CHI has no power to force the trust to carry out changes, but it argues reports like this demonstrate that problems in the health service are now being spotted before they become crises.

The trust is made up of a network of eight hospitals including two main district general hospitals at Epsom and St Helier.