An NHS trust has been told it must improve after inspectors found it was understaffed and some patients may not have received their medicines.

Health watchdog the Care Quality Commission (CQC) visited North Middlesex University Hospital NHS Trust in September and December last year.

The trust, which runs North Middlesex University Hospital as well as a number of smaller clinics, was rated ‘requires improvement’ overall.

Inspectors found that staff did not always manage patients' medicines safely, and that some might have missed doses, putting their health at risk.

Low staffing was also highlighted as an area for concern, as well as a lack of up-to-date training for workers in areas such as life support and dementia awareness.

Jane Ray, CQC deputy director of operations in London, said that while the trust was “largely a positive place to work”, staff had told inspectors bullying and harassment were an issue on some teams.

She also said that leaders at the trust needed to better manage the workload associated with a proposed merger with the Royal Free London NHS Foundation Trust.

Ray added: “Leaders were already struggling to complete some work, such as responding to complaints and investigating serious incidents, in a timely manner.

“This meant that improvements to people’s care weren’t always carried out as fast as needed.”

Inspectors ultimately decided to drop the trust’s overall leadership rating from ‘good’ to ‘requires improvement’ compared to a 2019 inspection.

Despite the challenges faced by the trust, the CQC said that most staff treated people with “compassion and kindness”, as well as respecting their privacy and dignity.

The effectiveness of the trust’s medical wards was also praised for taking into account people’s individual needs, with inspectors improving this specific rating to ‘good’.

Most patients also gave the trust positive feedback, telling the health watchdog that they felt safe.

Ms Ray said: “We found the trust’s leaders were honest about the challenges they faced and were taking action.

“We’ve shared our findings with them so they know where improvements must be made and will continue to monitor the trust closely, including through further inspections to ensure this happens.” 

Overall, the trust was rated 'requires improvement' for safety, effectiveness, responsiveness and leadership, but 'good' for how caring its services are. 

North Mid chief executive Dr Nnenna Osuji said: “I am of course disappointed that our rating for ‘well-led’ has fallen from ‘good’ to ‘requires improvement’, and I, together with our leadership team and board, will continue to examine our processes and practices to improve, and to deliver further improvements for our staff, patients, and local community.

“From recent feedback, including the CQC report published today, I know also that we have some work to do in terms of improving culture among some teams and services, and we are not shying away from this responsibility."