Epsom and St Helier NHS Trust Given Requires Improvement Leadership Rating

The Care Quality Commission (CQC) has rated the leadership of Epsom and St Helier University Hospitals NHS Trust as Requires Improvement following an inspection in May 2026, citing concerns about safety management, consistency of care and workforce inequalities.

The trust provides hospital and community services to around 490,000 people across London and Surrey, operating two main hospital sites alongside additional registered locations.

CQC inspectors found that differences in organisational structures across the trust’s main hospitals affected leaders’ ability to identify and respond to problems. Although management frameworks were in place, safety risks were not always managed consistently, and there was limited evidence of timely action to address concerns previously identified in maternity, surgery and urgent and emergency care.

The inspection also found ongoing challenges in staff experience, including bullying and harassment, particularly affecting employees with disabilities or long-term health conditions. Workforce data showed that Black staff and people from ethnic minority backgrounds were less likely to be recruited and remained under-represented in senior management. Recruitment processes designed to reduce bias were not consistently followed.

Inspectors noted improvements in complaints management, with the trust receiving 5% fewer complaints than the previous year. However, delays in responding to staff concerns and inconsistent communication about lessons learned from incidents remained areas for improvement.

The trust had also invested significantly in digital and IT systems, including introducing a new electronic record system in 2025. Further work was needed to ensure staff received adequate training and could access the information required to support patient care.

CQC also highlighted risks associated with ageing or poorly maintained buildings, which continued to affect care and safety, particularly in the emergency department.

Positive findings included the trust’s work on environmental sustainability, the introduction of a health equity dashboard to monitor inequalities, and collaboration with partner organisations to improve local services. Inspectors also noted more open information-sharing, shorter waiting times and a reduced need for hospital admissions.

CQC said the trust’s leadership understood the improvements required and confirmed that it would continue to monitor progress to help ensure people remained safe while changes were implemented.

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