Orpington Hospital is part of King's College Hospital NHS Foundation Trust and provides medical services to a population of approximately 300,000 people living in the London Borough of Bromley.

King's College Hospital NHS Foundation Trust employs around 11,723 whole time equivalent (WTE) members of staff, with approximately 220 WTE working at Orpington Hospital.

We carried out an announced inspection of Orpington Hospital on 16 April 2015.

Overall, this hospital is rated as being 'good'. Both surgery and outpatients and diagnostic imaging were rated as 'good' overall.

The five key questions, safety, effectiveness, caring, responsiveness and well-led were all found to be was 'good' overall at this hospital.

Our key findings were as follows:

Safe

• There was a formal process for reporting incidents and near misses and the sharing of information, including learning from incidents that took place.
• There were effective arrangements in place to minimise the risk of infection to patients and staff.
• Arrangements were in place to ensure staffing numbers and the skills mix was appropriate to support the delivery of patient care safely.
• The departments were clean and well maintained.
• Equipment was readily available and staff were trained to use it safely.

Effective

• Patients had been assessed, treated and cared for in line with professional guidance.
• Patients reported that their pain was assessed and treated.
• The nutritional needs of patients were assessed and patients were supported to eat and drink where their needs indicated.
• Staff received an annual performance review and had opportunities to discuss and identify learning and development needs through this review and other supervision meetings.
• There was access to Allied Health Professions services, such as physiotherapy out of hours.
• There was evidence of multidisciplinary working, which promoted effective patient treatment.

Caring

• Patients were satisfied and involved with their treatment and care and their privacy and dignity was respected.
• There was access to counselling and other services where patients required additional emotional and psychological support.

Responsive

• Patient access and flow through the surgical areas was planned around their needs.
• The surgical theatres were not always effectively utilised to their full capacity.
• Arrangements were in place to support people with disabilities and cognitive impairments, such as dementia.
• Translation services were available and information in alternative languages could be provided on request.
• The complaints process was understood by staff and patients had access to information to support them in raising concerns.
• Staff responded to patients’ individual needs and supported them throughout their journey at the hospital during their appointment.

Well-led

• Staff understood the vision of the trust and hospital and they could demonstrate how this was implemented in practice.
• Senior leaders understood their roles and responsibilities and monitored the standards of service provision.
• There were effective governance arrangements to facilitate monitoring, evaluation and reporting back to staff and upwards, to the trust board.
• The surgical directorates identified actual and potential risks at service and patient levels and had mechanisms in place to manage such risks, as well as to monitor progress.
• The culture amongst staff was of sharing and participative engagement, with openness to feedback and learning.

There were also areas of poor practice where the trust needed to make improvements.

The trust must:

• Ensure patients are seen in outpatient clinics with their full set of medical notes.

The trust should:

• Undertake medication audits in the outpatients and diagnostic imaging department.
• Ensure that a radiation protection supervisor is onsite.
• Conduct audits of the radiology reporting times.
• Undertake daily safety checks of the imaging and diagnostics department.

Professor Sir Mike Richards

Chief Inspector of Hospitals