Generating key takeaways...
A South West London NHS trust faces a required improvement notice after staff reports of racism, bullying, and harassment, exposing deep-rooted cultural issues amid ongoing reforms.
An NHS trust in South West London, responsible for services at St George’s Hospital in Tooting and Queen Mary’s Hospital in Roehampton, has been told it must improve after numerous staff raised concerns about racism, bullying, and harassment within the organisation. Following a Care Quality Commission (CQC) inspection in February, the trust’s leadership was rated as “requires improvement,” signalling significant challenges still to be addressed.
Feedback from staff painted a troubling picture of what some described as a “toxic culture” marked by “distressing experiences,” including discriminatory and abusive behaviour. Many employees reported feeling fearful of raising concerns about patient safety due to potential retribution. Moreover, there was a perception among some that the trust did not fully understand or support the experiences of people from black and minority ethnic backgrounds, contributing to a culture seen as exclusive rather than inclusive. Issues raised included persistent racism, bullying, harassment, and concerns that race and gender acted as barriers to being heard. Some staff cited a blame culture that was at times unprofessional and lacking accountability, consistent with poorly embedded values and leadership cohesion.
The CQC’s report underlined that measures aimed at tackling discrimination in recruitment and career progression have so far been ineffective, with gaps in leadership oversight hampering swift action on safety risks. While the trust published a group strategy in May 2023 aiming to enhance service quality, it was evident that not all staff understood their role within this framework. This disconnect was further complicated by difficulties in merging the culture and leadership between St George’s and the recently integrated Epsom and St Helier University Hospitals NHS Trust, which share an executive team. The CQC noted missed opportunities for collaborative learning and highlighted tensions between executive leaders and front-line managers, which have slowed improvements, particularly in maternity services.
Despite these concerns, the watchdog recognised some positive developments. The trust partnered with others to open a new orthopaedic centre, reducing hospital stays for patients. Additionally, it maintains a dedicated research and innovation team involved in over 300 clinical trials aimed at advancing healthcare. Improvements in specialties such as urology and community care projects designed to support frail individuals were also noted as examples of good partnership working.
Antoinette Smith, deputy director of operations at the CQC London office, emphasised the need for urgent action on cultural issues. Speaking about the inspection findings, she said, “It’s absolutely critical that the trust tackle this as a priority. Everyone should feel respected, and able to speak up and be listened to. Staff have important information to share that can keep people safe.” She acknowledged the trust’s commitment to improvement but warned that the cultural change necessary remains a significant challenge.
In response, St George’s University Hospitals NHS Foundation Trust acknowledged that any staff member feeling unheard or unsupported was one too many. A trust spokesperson stated, “We fully accept this rating is not where we want to be for our staff and local communities.” The trust asserted it has already taken immediate steps to bolster support for staff and strengthen oversight of quality and safety across its services, while committing to further efforts to listen to colleagues and enhance the diversity of leadership teams.
The issues uncovered at St George’s fit within a broader national context where concerns over bullying, racism, and toxic culture have been reported across several NHS trusts. Independent investigations into other trusts, like University Hospitals Birmingham and Leeds Teaching Hospitals, have revealed similarly high levels of staff bullying and harassment, with leadership often criticised for failing to respond adequately. The CQC’s increasing focus on leadership and culture ratings reflects a systemic push to address these deep-rooted problems, highlighting that the safety and wellbeing of both staff and patients are closely intertwined with organisational culture.
St George’s ongoing challenges underline the complexity of changing entrenched behaviours and attitudes within large healthcare organisations, especially during periods of structural change and leadership reconfiguration. However, the trust’s engagement with partnerships, research initiatives, and community projects shows a commitment to improvement alongside the necessary cultural reforms. The CQC will continue to monitor progress through upcoming inspections to ensure that these improvements result in a safer, more inclusive working environment and higher-quality care for the population of approximately 1.3 million people served by the trust.
📌 Reference Map:
- Paragraph 1 – [1] (MyLondon), [2] (St George’s NHS Trust)
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- Paragraph 10 – [1] (MyLondon), [2] (St George’s NHS Trust)
Source: Noah Wire Services
Noah Fact Check Pro
The draft above was created using the information available at the time the story first
emerged. We’ve since applied our fact-checking process to the final narrative, based on the criteria listed
below. The results are intended to help you assess the credibility of the piece and highlight any areas that may
warrant further investigation.
Freshness check
Score:
8
Notes:
The narrative is recent, published on 1 November 2025. The Care Quality Commission’s (CQC) report, referenced in the narrative, was published on 24 October 2025. ([gov.uk](https://www.gov.uk/government/publications/state-of-health-and-adult-social-care-in-england-2024-to-2025?utm_source=openai)) The CQC’s annual report for 2024 to 2025, released on 24 October 2025, assesses the quality of health and social care in England, including findings related to St George’s University Hospitals NHS Foundation Trust. ([gov.uk](https://www.gov.uk/government/publications/state-of-health-and-adult-social-care-in-england-2024-to-2025?utm_source=openai)) The narrative includes direct quotes from the CQC’s deputy director of operations, Antoinette Smith, and a trust spokesperson, indicating original reporting. No evidence suggests the content is recycled or republished from low-quality sites. The inclusion of recent data and direct quotes supports a high freshness score. However, the narrative may have been influenced by the CQC’s report, which is typical for such coverage. No discrepancies in figures, dates, or quotes were identified.
Quotes check
Score:
9
Notes:
The direct quotes from Antoinette Smith and a trust spokesperson are unique to this narrative. No identical quotes were found in earlier material, indicating original reporting. The wording of the quotes matches the sources cited, with no variations noted. The absence of earlier matches suggests the content is potentially original or exclusive.
Source reliability
Score:
9
Notes:
The narrative originates from MyLondon, a local news outlet. While not as widely known as national media, MyLondon is a legitimate news source covering London and surrounding areas. The CQC’s report, referenced in the narrative, is an official document published by a reputable government agency. The trust’s spokesperson’s statements are sourced directly from the trust’s official communications. The use of direct quotes from these reputable sources enhances the reliability of the narrative.
Plausability check
Score:
8
Notes:
The narrative’s claims align with the CQC’s findings, which highlight issues of racism, bullying, and harassment within the trust. The CQC’s report, published on 24 October 2025, assesses the quality of health and social care in England, including findings related to St George’s University Hospitals NHS Foundation Trust. ([gov.uk](https://www.gov.uk/government/publications/state-of-health-and-adult-social-care-in-england-2024-to-2025?utm_source=openai)) The trust’s response, acknowledging the need for improvement and outlining steps to address the issues, is consistent with the narrative. The inclusion of direct quotes from Antoinette Smith and a trust spokesperson adds credibility. No evidence suggests the narrative is fabricated or contains significant inaccuracies.
Overall assessment
Verdict (FAIL, OPEN, PASS): PASS
Confidence (LOW, MEDIUM, HIGH): HIGH
Summary:
The narrative is recent, with direct quotes from reputable sources, and aligns with the CQC’s findings, indicating a high level of credibility.
