Hospital bosses criticised for workplace culture

Hospital staff have raised "concerns around alleged discrimination in leadership and recruitment" during an inspection of their NHS trust, a regulator says.

The Care Quality Commission (CQC) rated leadership at Epsom and St Helier University Hospitals NHS Trust as "requires improvement" after an inspection in May.

Staff told inspectors during the assessment of "poor cultural practices" at the trust and that "managers were slow to take actions", according to the CQC report.

The trust said inspectors "found many strengths" and its focus was on making sure they were "felt consistently by every patient and colleague".

Epsom and St Helier University Hospitals NHS Trust manages hospitals in Epsom, Surrey, and in Sutton, London, as well as some specialist services.

The CQC said staff had reported "bullying and harassment", particularly in pharmacy and surgery, and a "fear of reprisal when speaking up".

Some staff had described a "supportive place to work where diversity was embraced in parts of the organisation", according to inspectors.

But others had "raised concerns relating to bullying and harassment, racism, and perceived unfair treatment".

The CQC said black and minority ethnic staff were "over-represented in lower pay bands and under-represented at senior levels".

Inspectors wrote that there had been "a lack of pace" towards targets for improving workplace culture and that executives acknowledged embedding their strategy "had taken longer than anticipated".

There was evidence of "strong leadership in some areas" but this was "not consistent across the organisation", the CQC said.

The trust was "actively engaged in a process of self-improvement and culture change, largely in response to external reviews and staff feedback", according to the report.

The CQC described the trust's estates as a "significant risk" due to the age and condition of some areas.

The regulator wrote that investment was planned to manage "some of the most challenging areas".

But in "urgent and emergency care particularly", the condition of buildings was impacting "the safety, privacy and dignity and care" of patients, inspectors found.

A previous inspection in 2024 also highlighted crumbling facilities.

The trust secured £57m of government funding in June to redevelop St Helier Hospital's emergency department.

The CQC wrote that there had been "a lack of stability" on the trust's board but that permanent appointments had been made shortly after the May assessment.

Inspectors also found that "engagement with clinical sustainability initiatives and workshops was not consistent across all divisions".

Epsom and St Helier University Hospitals NHS Trust chief executive Chinyama Okunuga said: "The CQC consistently heard that patients felt listened to, respected and well cared for, often in challenging circumstances.

"Inspectors found many strengths, including capable leaders, clear strategies, stronger complaints handling and partnership working."

Antoinette Smith, the CQC deputy director of hospitals in London, said the inspection had found "shortfalls in safety management and ensuring a consistent standard of care and strategic focus".

"We've shared our concerns with the trust's leadership, and they understand the improvements they need to make," she said.

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