England's Care Quality Commission has rated leadership at Epsom and St Helier University Hospitals NHS Trust as requiring improvement, citing delayed action on known risks in maternity, surgery and emergency care. The watchdog's May inspection also identified worsening workforce inequalities and unresolved bullying complaints, particularly affecting disabled staff, alongside some genuine gains in patient waiting times and digital systems.
What inspectors found
The CQC said there was "limited evidence" that trust leaders had moved quickly enough to reduce avoidable harm, despite prior inspections and the trust's own incident data already flagging problems in maternity, surgery, and urgent and emergency care. Antoinette Smith, the CQC's deputy director of hospitals in London, said the trust had set up a management model for its sites but that its two main hospitals - Epsom Hospital and St Helier Hospital, which together with Queen Mary's Hospital for Children serve roughly 490,000 people across London and Surrey - operated under different organizational structures. That inconsistency, she said, limited leaders' ability to spot and respond to problems, though the trust was already aware of the gap and had plans in place to address it.
Inspectors also raised concerns about the physical condition of some trust buildings, describing aging or deteriorating facilities as a "significant safety risk" that was affecting patient care, especially in the emergency department.
Workforce concerns deepen
Staff experience, flagged in a previous inspection, remains a problem area. The CQC found that bullying and harassment persist, particularly toward staff with disabilities or long-term health conditions, and that broader workforce disparities have worsened rather than improved. Inspectors noted that recruitment processes designed to reduce bias were not being consistently applied, and that data showed Black staff and those from other ethnic minority groups were less likely to be hired and remained under-represented in senior management roles.
Areas of improvement alongside the criticism
The report was not wholly negative. Complaints fell by 5 percent compared with the previous year, and the trust improved how it handled them, though inspectors said leaders still needed to respond more quickly to staff concerns. The CQC also praised collaboration with partner organizations that has helped shorten patient waiting times and reduce hospital admissions. A health equity dashboard has been introduced to track and address inequalities, and the trust has invested in digital infrastructure, including a new electronic patient record system launched in 2025 - though inspectors said staff still need more training to use it fully.
Trust response
Chinyama Okunuga, the trust's site chief executive officer, said the CQC had recognized staff "working incredibly hard to provide compassionate care, often in challenging circumstances," while acknowledging the report's findings. The trust said it is taking steps to strengthen risk identification, tackle inequalities and better support staff. The CQC said it has shared its concerns directly with trust leadership and will continue monitoring progress to ensure patient safety during the improvement process.