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Improving clinical quality

Our long tradition of clinical excellence continues today with some of the best clinical results in the UK.

Britain’s best record on mortality

The Good Hospital Guide published by independent healthcare experts Dr Foster in 2005, showed that, for the fifth year running, Barts and The London maintained one of the lowest mortality rates in the country – 23% better than the national average, the second lowest in the UK. Mortality rates, which refer to the number of patients who have died in hospital, are generally taken as a significant indicator of clinical excellence overall.

The Trust’s hospitals also scored highly on emergency care, heart services and hip replacement services in this year’s guide, while The Royal London Hospital was one of only five hospitals in the UK to be shortlisted for Dr Foster’s hospital of the year award.

Top rating for clinical quality

Barts and The London was again placed in the top band of performance in the clinical focus category of the new Healthcare Commission ratings, which measure trusts against 10 clinical focus targets, and band them at levels from 5 (good) to 1 (poor). The Trust scored at level 3 or above for all measures, and at the highest levels against four measures in this category – child protection, participation in audit, stroke care and thrombolysis (a composite of the percentage of eligible patients receiving thrombolysis within 60 minutes of a call being made and 30 minutes of hospital arrival).

Attracting leading specialists

Over the course of a year Barts and The London clinicians see some of the most seriously ill patients in London. This high concentration of complex cases means that we attract some of Britain’s leading specialists – expertise that benefits all our patients, including those coming in for more routine issues.

Clinical Effectiveness Unit

The Trust’s Clinical Effectiveness Unit continues to support the audit of clinical services to ensure they are of a high standard, evidence-based and follow best practice. In partnership with clinicians, the unit also ensures that national guidelines are reviewed and actioned so that we deliver high-quality patient care and continually improve the patient experience.


Auditing risk factors

Barts and The London performed exceptionally well against the NHS Litigation Authority’s Clinical Negligence Scheme for Trusts (CNST), on which we were audited in February 2003, retaining Level 1 status. The CNST measures hospital trusts against 10 clinical risk management standards focused on supporting patient safety.

Maternity services have performed well for the second time in achieving CNST Level 2, when they were audited in April 2004. CNST assesses maternity services in the UK against eight clinical risk standards which, if in place, demonstrate that high quality and safe care for mothers and babies is being provided and that the service has a ‘safety awareness culture’ embedded in its clinical practices. More>>

The Trust also passed Level 1 of the Risk Pooling Scheme for Trusts (RPST) assessment, achieving the highest scores of any Trust assessed at that time. The RPST risk management standard aims to ensure that all NHS organisations have a rigorous risk management process that covers all risks embedded within their system of internal control.


New quality standards

New quality standards – Standards for Better Health – were introduced in the NHS in July 2004 to describe the level of quality that healthcare organisations are expected to meet in terms of safety, clinical and cost effectiveness, governance, patient focus, accessible and responsive care, the care environment and amenities, and public health.

From 2005, all NHS trusts need to carry out annual self-assessment to demonstrate that these standards are being met, both to patients and to the new Healthcare Commission – the national body that promotes improvements in the quality of health care and public health in England and has a statutory duty to assess the performance of healthcare organisations.

While service improvements and action to meet the core Standards for Better Health directs much of the Trust’s clinical governance work, we also continue to address key areas previously covered by the former Commission for Health Improvement (CHI) action plan.

Annual Health Check - final declaration

The Healthcare Commission's new Annual Health Check system of assessment replaces the NHS star ratings and is designed to provide a fuller picture of the performance of a trust against the core and developmental standards that were set by the Department of Health in July 2004.

As part of the Annual Health Check, trusts were required to submit their final declaration of their compliance against the 24 core standards covering the whole year to the Healthcare Commission by 4 May 2006. A copy of the Trust's final declaration as submitted to the Healthcare Commission is available below. In addition to the Trust's self assessment of compliance against the core standards, the declaration includes comments received from the Strategic Health Authority, the Patient and Public Involvement Forum and local authority Overview and Scrutiny Committees.

Download Healthcare Commission Final Declaration, May 2006.


Healthcare Commission formerly Commission for Health Improvement (CHI)

CHI published a report into its routine clinical governance review of Barts and The London in October 2001. The report included the findings from CHI's inspection visit to Barts and The London, together with other data measuring the Trust's performance against established criteria. It also contains feedback from patients, partner organisations' and other individuals and groups with an interest in the Trust, compiled throughout the review process.

Click here to read the Barts and The London CHI report

While CHI reported high/satisfactory standards of clinical care, some areas were identified for targeted improvement action: medical records, radiology, and surgery and theatres.

The Trust continues to implement the improvements committed to in its Commission for Health Improvement (CHI) action plan:

  • Meeting national complaints targets
  • Improving access and waiting times in diagnostic services
  • Establishing a Health Records Improvement Board and action plan
  • Surveying maternity users and implementing an action plan
  • Improving Working Lives activities
  • Leadership Development Programme
  • Inter-organisational clinical governance activity via National Service Framework (NSF) clinical networks, groups and joint boards with primary care and social care partners

In April 2004, CHI was replaced by a new organisation called The Healthcare Commission. More>>