We seek to provide high quality, safe patient care and continuously improve the service we offer patients, whilst also using our resources more effectively.
In this section you will find information about our inspection ratings, our patient safety programme, how we are safeguarding children and adults, our speaking up policy and our quality report from the current and past years.
We hope that if you are a member of the public needing hospital treatment, sharing our quality and safety information will allow you to see the standards we adhere to and encourage you to choose our services.
The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England.
It ensures health and social care services provide people with safe, effective, compassionate, high-quality care and encourages services to improve.
The CQC monitors, inspects and regulates services to make sure they meet fundamental standards of quality and safety and publish what they find, including performance ratings to help people choose where they have their care.
Trusts are rated as either outstanding, good, requires improvement or inadequate.
The last time the Royal Free London was inspected (11 December 2018 to 10 January 2019), significant areas of good and outstanding practice was identified despite a fall in our overall rating to 'requires improvement'.
We received three ‘good’ ratings for being effective, caring and well-led.
Inspectors found that services were safe and responsive, however, they said improvements were required in these areas.
Our ambition is to move to ‘outstanding’ and we undertake quarterly CQC self-assessments to ensure standards are being met across services and sites.
Individual hospital ratings
|Site||CQC rating||Inspection report|
|Trust overall||Requires improvement||View the report|
|Royal Free Hospital||Requires improvement||View the report|
|Barnet Hospital||Requires improvement||View the report|
|Chase Farm Hospital||Good||View the report|
We are committed to delivering care and services that are safe, effective, caring, responsive and well-led.
Hundreds of patients come through our doors daily. Most receive treatment, get better and can return home or go to other care settings. We do all we can to deliver harm-free care for every patient, every time they are seen.
However, healthcare does carry some risk and while everyone in the NHS works hard every day to reduce this risk, harm still happens.
When harm occurs and results in a patient safety event, we respond quickly to understand what has led to the harm and where necessary, put improvements in place.
As part of a national initiative, we are implementing the Patient Safety Incident Response Framework (PSIRF), which will replace the Serious Incident framework (2015). This will assist us in learning from patient safety events when they occur.
The main principles of PSIRF are:
- compassionate engagement and involvement of those affected by patient safety events
- application of a range of system-based approaches to learning from patient safety events
- considered and proportionate responses to patient safety events and safety issues
- supportive oversight focused on strengthening response system functioning and improvement
Understanding our safety profile
Our trust has a continuous commitment to learning from patient safety events and we have developed our understanding and insights into patient safety matters over a period of years.
The patient safety team has engaged with key stakeholders, both internal and external, and reviewed data from various sources to arrive at a trust safety profile.
This process has also helped us to identify the methods we will be using to maximise learning and improvement. We have captured this in our PSIRF policy which we will publish shortly.
Engaging with those affected by patient safety events
We recognise that learning and improvement following a patient safety event can only be achieved if supportive systems and processes are in place for those who have been involved, including patients, families and staff.
Patients and families often provide a unique, or different perspective to the circumstances around patient safety events and may have different questions or needs to that of the organisation.
We also know from evidence that when patients are treated as partners in their care, significant gains are made in safety, patient satisfaction and health outcomes.
By becoming active members of the healthcare team, patients, carers and communities can contribute to the safety of their care and that of the health care system as a whole.
This helps us to:
- be more open and transparent on learning
- understand the actual safety experience of our patients and what makes them feel unsafe
- make improvements
We are committed to involving patients and families in our safety work.
Our patient safety partners and patient representatives are supporting our work to strengthen our processes to provide compassionate engagement and to involve more patients improving the safety of their care and that of the trust as a whole.
We work collaboratively with Barnet, Enfield, and Camden Safeguarding Adults Partnership Boards to safeguard and protect our patients from harm and abuse.
We also work with multi-agency partners across London and the UK to prevent exploitation, abuse or neglect for people who use our services.
Our staff are equipped with the relevant training, knowledge, skills, and resources to enable them to respond quickly and appropriately to keeping our patients safe.
The safeguarding adults team covers all elements of safeguarding according to the Care Act 2014, including harmful practices.
If you or another adult are at risk of being harmed in any way by another person, you should contact social care for the area you live in as follows:
Other support and contact information
We work in partnership with Victim Support, Solace Women’s Aid and Camden Safety Net to support victims who suffer from domestic and sexual abuse through effective safety planning and protective measures.
You can contact the following agencies for support:
- Victim Support: 0808 168 9111 (24 hours)
- Solace Women’s Aid: 0808 802 5565
- Camden Safety Net: 020 7974 2526
- 24-hour National Domestic Violence Helpline on 0808 200 0247 (this number can also be used for general support out of hours and on bank holidays)
We take several steps to ensure we follow robust safeguarding procedures for children at each of our hospitals.
Every member of hospital staff employed by the trust understands they have a responsibility to safeguard children and they are supported by the named doctor and nurse in doing this.
We follow the guidance in the London child protection procedures and work closely with multi-disciplinary colleagues.
The safeguarding procedures in place for vulnerable children include:
- a proactive safeguarding children team
- flagging systems for children subject to child protection plans
- a robust child protection training schedule
- written updates for all hospital staff on safeguarding procedures and issues
- participation in multi-agency audits and active participation in local safeguarding children boards and related groups
If concerns are raised about a child, we need to investigate this fully and a skeletal survey may be carried out to check for signs of injury or an underlying medical condition.
Find out more about skeletal surveys in children.
Every year, all NHS hospitals must produce a report detailing the quality of their care provision and outlining their priorities for the year ahead.
This quality account outlines how we are improving the care our patients experience, while also using our resources more effectively, reflecting on our progress against three indicators of quality:
- Patient safety — having the correct systems and staff in place to minimise the risk of harm to our patients, being open and honest, and learning from mistakes if things go wrong.
- Clinical effectiveness — providing the highest quality care with world-class outcomes whilst also being efficient and cost effective.
- Patient experience — meeting our patients’ emotional needs as well as their physical needs.
You can read our latest reports here:
We welcome feedback on our quality accounts. If you would like to share your views, please email rfquality
Patient safety is our primary concern, and our staff are often best placed to identify if care may be falling below the standard our patients deserve.
In order to ensure our high standards continue to be met, we encourage every member of our staff to raise concerns with their line manager or another member of the management team.
We want everyone in the organisation to feel able to highlight wrongdoing or poor practice when they see it and feel confident their concerns will be addressed in a constructive way.
We promise our staff that where they identify a genuine patient safety concern, we shall not treat them with prejudice and they will not suffer any detriment to their career. Instead, we will support them while we fully investigate and, if appropriate, act on their concern. We will also provide feedback about how we have responded to the issue they have raised.
The trust has a speaking up policy which incorporates the recommendations from the Sir Robert Francis QC’s final report following the Freedom to Speak Up review.
It demonstrates the trust’s commitment towards tackling malpractice and wrongdoing to ensure all staff feel comfortable and safe in speaking up and raising concerns within their workplace.
The policy includes a clearer framework to encourage staff to speak up and raise concerns and sets out a pathway which includes six different routes staff can follow to raise their concerns.
It also signposts to various sources of support (internal and external to our trust) that are available to staff who wish to raise concerns.