The health service watchdog has ordered the NHS Trust that runs Epsom and St Helier hospitals to improve in all areas.

The Care Quality Commission's (CQC) report, published on Friday, said the trust required improvement in all five of the areas on which it was rated.

Surgery at St Helier Hospital was highlighted as inadequate, with inspectors who visited in November raising concerns that staff shortage shortages could harm patients and had led to a rise in cardiac arrests.

Not all surgical staff received the required training or annual appraisals, meaning inspectors could not be assured staff were competent in their roles, according to the report.

Medical care, A&E, intensive care, maternity and gynaecology, children and young people units were all deemed to require improvement, according to the CQC.

Low nurse staff levels were putting the quality of patient care at risk and there was no plan to address staffing shortages as they happened, the report also found.

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Epsom and St Helier University Hospitals NHS Trust provides services to approximately 420,000 people living in south-west London and north-east Surrey.

It offers services across its two sites - Epsom General Hospital, in Dorking Road, and St Helier Hospital, in Wrythe Lane.

The overall rating given to the trust was "requires improvement," based on a combination of the watchdog’s findings during its inspection, and information from both its monitoring system and patients and other organisations.

The trust was rated "requires improvement" for the five overall categories on which it was rated - safety, effectiveness, caring, responsiveness, and leadership.

CQC inspectors carried out an announced inspection between November 10 and November 13 last year, and undertook unannounced visits later in the month.

Both hospitals were deemed to require improvement overrall. 

In its summary, the report stated: “The existing estate in some areas was not fit for the purpose of delivering modern healthcare.”

It added: "There was a significant shortfall of staff in a number of areas including critical care, medicine, surgery, and maternity services.

"Inappropriate skill mix issues and staffing numbers had been identified as contributing factors in a marginal increase in the number of ward-based cardiac arrests identified by the trust between April and September 2015.

"Additionally, staff shortages were identified as impacting on the ability of staff to consistently provide individualised, evidence based and compassionate care."

Daniel Elkeles, chief executive of the trust, said: "The report recognises the challenges that we have faced in many of our services given the uncertainty about our hospitals’ future over so many years and the poor quality of our buildings."

He added: “Whilst we accept all the issues the CQC have raised, given these significant challenges it is a great tribute to our staff how well they have delivered care.

“Many of the areas that they identified were already the subject of improvement programmes and CQC highlighting of them has helped us accelerate progress.

“We have robust plans in place to improve in all the areas that they identify.”

The watchdog found a lack of leadership and evidence of "inappropriate behaviour," according to a report from the trust’s chief executive on informal feedback the watchdog gave at the time of inspection.

NOVEMBER: Watchdog exposes inappropriate behaviour at Epsom and St Helier hospitals

Mr Elkeles said the the CQC were assured the trust responded appropriately to concerns.

The Epsom site’s hip and knee replacement centre was rated outstanding by the watchdog.

The trust’s renal service, outpatients and diagnostics, and end of life care were rated good.

Mr Elkeles added: “There is a lot that the trust does outstandingly well and our teams should feel justly proud. I am pleased that the CQC have recognised this.

“We do recognise, however, that there are areas that we need to improve and we accept all of the findings of the CQC report. We are determined to make the required improvement in the areas that they have highlighted.

“In our five-year strategy, which we published in April 2015, we recognised that one of our challenges was to consistently provide high quality care across all of our services, and the CQC report confirms for us that we still have work to do to ensure that we are achieving this."