Hospital with record debt ‘is overcrowded and has gone backwards on emergency care’

The London hospital trust with the biggest debt in NHS history has “gone backwards” on emergency care, inspectors warned today.

The Care Quality Commission reported “significant overcrowding” in A&E at Princess Royal hospital, in Orpington, with patients on trolleys in corridors and cubicles designed for one patient being used by two.

There was a shortage of surgical beds which meant that patients had to be kept in operating theatres while they recovered. There were also reports of a lack of training for junior doctors, low morale among admin staff and perceptions of bullying. Staff in some clinical areas did not feel valued or respected.

King’s College Hospital NHS Trust, which runs the Princess Royal and King’s College hospital in Denmark Hill, was kept on its previous rating as “requires improvement”, the second lowest of four categories.

The trust, which has had longstanding financial problems, ran up debts of between £180 million and £191 million in 2018/19, a spokeswoman confirmed today. It has almost 12,500 staff and more than 1,600 beds. It treats 176,000 inpatients, 1.8 million outpatients and 229,000 people in A&E each year.

Today’s CQC report said there was a “lack of effective leadership” in the emergency department at Princess Royal, which had got worse since the last inspection. England’s chief inspector of hospitals, Professor Ted Baker, said: “It is disappointing that there has been no overall improvement in the rating at King’s College Hospital NHS Foundation Trust. In fact, in some areas the trust has gone backwards. For example, there was a lack of effective leadership in the emergency department at Princess Royal University Hospital. This had got worse since CQC’s previous inspection. While the trust was rated Good overall for caring and there were some examples of outstanding practice, care is not consistently high quality in all services. The trust must take action in response to this report to address this.”

A trust spokeswoman said: “The report recognises improvements in maternity, end of life care and for patients with mental health conditions at King’s College Hospital.

“We have already taken immediate action to tackle the issues at the Princess Royal University Hospital emergency department and improve our performance as well as working with staff to improve morale.”