Leadership at North Mid rated ‘requires improvement’ by latest CQC report

An inspection last autumn was prompted in part by concerns staff raised with the health watchdog about the NHS trust’s culture

The main entrance to North Mid is accessed via Bull Lane, where Enfield Council wants to install a bus gate restricting motor traffic
North Middlesex Hospital

North Middlesex University Hospital NHS Trust’s leadership team has been given a downgraded rating following an inspection by the Care Quality Commission (CQC).

CQC lowered the rating for the Edmonton hospital’s overall leadership from ‘good’ to ‘requires improvement’, and again rated it ‘requires improvement’ for medical care, following inspections in September and December. The overall rating for the trust remains ‘requires improvement’. 

The inspection of the trust’s overall leadership was prompted in part by concerns staff raised to the CQC about the organisation’s culture. Inspectors also assessed the trust’s medical care services, because concerns had been raised to CQC about care for elderly people and people with sickle cell disease. 

The trust is currently in the process of a proposed merger with the Royal Free London NHS Foundation Trust and was managing this alongside people’s ongoing care.

Jane Ray, CQC deputy director of operations in London, said: “When we inspected the trust, we found a leadership team which was skilled and committed but needed to better manage the workload from a proposed merger with the Royal Free London NHS Foundation Trust. 

“Leaders were already struggling to complete some work such as responding to complaints and investigating serious incidents in a timely manner. This meant that improvements to people’s care weren’t always carried out as fast as needed.  

“While the trust was largely a positive place to work, staff told us issues of bullying and harassment in certain teams have persisted since our last inspection. Leaders must support these teams to urgently address this to ensure staff can work together well to meet people’s needs. Linked to this, formal processes to address HR issues are taking too long to resolve.  

“We found the trust’s leaders were honest about the challenges they faced and were taking action. We’ve shared our findings with them so they know where improvements must be made and will continue to monitor the trust closely, including through further inspections to ensure this happens.” 

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Since the inspectors’ visits, the annual NHS staff survey results have been published North Mid has improved over the past year on nearly three-quarters of the measures covered by the poll.

North Mid chief executive Dr Nnenna Osuji said: “We are grateful to patients, families, staff and others who take time to share their feedback with regulators like the CQC, and with us directly, so that we can ensure we are focusing on the right things that our patients, staff and community tell us are important to them.

“This is the sixth inspection of North Mid services since I joined the trust as chief executive in summer 2021, and I am thankful to everyone who has helped share their experiences, views, and ideas for how we can continually progress towards our vision of outstanding care for local people.

“Our recent staff survey results, together with our patient surveys, demonstrate we are making strides in this commitment. As the most improved trust among our provider cohort in this year’s annual staff survey, with healthy above-average response rates, we can be sure that for the majority of our staff, we are moving in the right direction.

“I am incredibly pleased – but not at all surprised – that the CQC inspectors found North Mid staff to be compassionate, dedicated, and firmly anchored in our fabulous local community. North Mid is at the heart of north London, and we are proud to employ a workforce which mirrors the talents and tenacity of our local population.

“The multi-faceted diversity that makes us strong also brings diversity of experience, opinions and ideas, and I want to be sure that the broad variety of views allows every voice to feel heard, particularly from people who feel seldom heard, and who are willing to ‘speak truth to power’ – some of the most meaningful changes come from courageous critics, and North Mid is open to learning from everyone.

“I am of course disappointed that our rating for ‘well-led’ has fallen from ‘good’ to ‘requires improvement’, and I, together with our leadership team and board, will continue to examine our processes and practices to improve, and to deliver further improvements for our staff, patients, and local community.

“From recent feedback, including the CQC report published today, I know also that we have some work to do in terms of improving culture among some teams and services, and we are not shying away from this responsibility. We will continue to focus on our mission to provide outstanding care to local people as well as our journey of improvement which will take time and unwavering dedication. We hope our staff, our patients, our populations, and our partners will continue to work with us to support this direction of travel.”

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