Watchdog damns 'deadly, reeking, filthy' hospitals

Deadly, filthy and reeking of urine was the verdict delivered on hospitals run by a trust in one of the most affluent areas of Britain yesterday.

The Commission for Health Improvement (CHI), the government watchdog set up to monitor the quality of health care, delivered its most damning report to date after a routine inspection at the Epsom and St Helier NHS trust in Surrey.

The trust, which includes two main hospitals, was criticised for its high death rate, for being dirty and badly run and for its defensive and closed style of management. The death rate after surgery at St Helier hospital, the largest in the trust with 600 beds, was among the highest of any comparable hospital after emergency and routine operations. Figures in the report showed its death rate after emergency surgery was 6,431 per 100,000 operations against a rate of 3,785 for comparable hospitals. For routine surgery, its death rate was 633 compared with 438.

Nigel Sewell, the chief executive, announced last week he was retiring early. The trust, which he has led for the two years since it formed after the merger of two smaller trusts, denied his decision to go was linked with the report. In a statement, the trust said he had been recognised as a "distinguished professor" by an international management school.

Peter Homa, the chief executive of CHI, said the trust needed to make a "serious commitment" to improving its performance. "The trust is currently forming an action plan in response to our report and this plan must demonstrate clearly what steps will be taken to improve patient care."

The investigation, part of a series being conducted by the CHI of every NHS trust in the country, uncovered serious deficiencies in many areas. The picture painted was of a hospital that belonged to the early years of the 20th century rather than the 21st. Carpeting in some wards was so disgusting that the team recommended it be removed and replaced "to eliminate the strong smell of stale urine". The number of complaints from patients has risen sharply and there were delays of up to three years in dealing with them, which the report says is unacceptable. Even then "resolution might still not be reached", it said.

There had been "little or no progress" on co-ordinating activity across the trust since the merger two years ago. Most staff thought the trust was a worse place to work than before the merger and there was "widespread dissatisfaction with senior management and board level leadership".

There was a "strong us and them culture" in both hospitals, it said. "The majority of staff felt not valued or supported by the executive team."

Jennifer Denning, Epsom and St Helier NHS Trust chairwoman, said: "The report, we feel, is a very fair picture of the trust and the board welcomes it greatly because it does give us the opportunity to see in one clear, focused document the things that we need to do."