Quality priorities
What are our quality priorities?
Our Quality Priorities for 2026/27 focus on areas where targeted improvement can make the greatest difference to patient safety, patient experience, clinical effectiveness and health inequalities.
The priorities have been selected following a review of improvement opportunities and evidence from a range of sources, including Getting It Right First Time (GIRFT), Model Hospital, claims, complaints, incidents and national audit data. We have also considered improvement work taking place across North West London, national priorities and locally identified improvement opportunities within our divisions.
Each priority has been aligned to a division to lead its implementation alongside local improvement work. Progress will be monitored quarterly through reporting to the Executive Management Board and Trust Standing Committee.
We are also working with our partner trusts in the North West London Acute Provider Group (APG) on shared priorities where there are opportunities to improve care across the system. These include antimicrobial stewardship, implementation of a joint reporting and management system, healthcare-associated infection surveillance and improving the safety and timeliness of inter-hospital transfers.
For 2026/27, Chelsea and Westminster Hospital NHS Foundation Trust has seven Quality Priorities.
Priority 1: Infection Prevention and Control (IPC)
Why we have chosen this as a quality priority
Infection Prevention and Control remains fundamental to patient safety and staff wellbeing. Trust data shows higher-than-expected rates of healthcare-associated infections, including Clostridioides difficile and MRSA, with variation across sites.
Preventing avoidable infection reduces patient harm, length of stay and risk of mortality, while improving patient experience and operational resilience.
What we aim to achieve in 2026/27
We aim to reduce hospital-acquired infections through strengthened prevention, surveillance and assurance. This will include consistent application of evidence-based IPC practices, improved understanding of variation between sites and enhanced learning from incidents.
Key deliverables
- Implement site-specific IPC improvement plans targeting healthcare-associated infection reduction by Q1
- Strengthen surveillance and reporting of MRSA and C. difficile by Q2
- Deliver refreshed IPC training and compliance monitoring by Q3
- Demonstrate sustained reduction in healthcare-associated infection rates and variation by Q4
Priority 2: Pressure Ulcer Prevention
Why we have chosen this as a quality priority
Pressure ulcers are largely preventable and remain a significant cause of avoidable patient harm. They can contribute to pain, infection risk, delayed recovery and increased length of stay.
Reducing hospital-acquired category 3 and 4 pressure ulcers is a national patient safety priority and an important indicator of the quality of fundamental nursing care.
What we aim to achieve in 2026/27
We aim to eliminate hospital-acquired category 4 pressure ulcers and significantly reduce category 3 pressure ulcers through consistent risk assessment, evidence-based prevention, improved documentation and strengthened learning from incidents.
Key deliverables
- Refresh Trustwide pressure ulcer prevention standards by Q1
- Improve compliance with risk assessment and repositioning documentation by Q2
- Deliver targeted ward-level improvement in high-risk areas by Q3
- Achieve zero hospital-acquired category 4 pressure ulcers by Q4
Priority 3: Antimicrobial Stewardship
Why we have chosen this as a quality priority
Optimising antimicrobial prescribing is essential to patient safety, clinical effectiveness and tackling antimicrobial resistance. Inappropriate antimicrobial use can expose patients to avoidable harm and contribute to resistance.
This priority aligns with the UK Antimicrobial Resistance Action Plan and focuses on safer, more standardised prescribing practice.
What we aim to achieve in 2026/27
We aim to reduce unnecessary antimicrobial exposure by improving appropriate antibiotic selection, increasing the use of first-line 'Access' antibiotics where clinically appropriate, improving intravenous-to-oral step-down and reducing inappropriate broad-spectrum use.
We will also standardise the management of key invasive infections to improve outcomes and consistency of care.
Key deliverables
- Increase the proportion of 'Access' antibiotic use by Q2
- Improve compliance with intravenous-to-oral step-down criteria by Q2
- Standardise treatment pathways for key invasive infections by Q3
- Reduce inappropriate broad-spectrum prophylactic prescribing by Q4
Priority 4: Reducing Noise at Night
Why we have chosen this as a quality priority
Patient feedback from the CQC National Inpatient Survey has highlighted night-time noise as a significant issue affecting rest and recovery.
Poor sleep can negatively affect patient experience, healing and wellbeing. Reducing avoidable noise at night demonstrates responsiveness to patient feedback and supports compassionate, patient-centred care.
What we aim to achieve in 2026/27
We aim to improve patient-reported sleep quality by reducing avoidable noise at night through environmental, behavioural and process changes, with a focus on sustainable ward-level improvements.
Key deliverables
- Identify key sources of night-time noise across wards by Q1
- Implement ward-based 'quiet at night' interventions by Q2
- Embed staff awareness and behavioural standards by Q3
- Improve patient-reported sleep measures and CQC survey results by Q4
- Monitor feedback from Friends and Family Test survey questions throughout the year
Priority 5: Reducing Inequalities in Early Antenatal Booking
Why we have chosen this as a quality priority
Black and Brown women are more likely to book later in pregnancy, limiting access to early screening, risk assessment and personalised care. Late booking contributes to inequalities in maternal and neonatal outcomes.
Improving early antenatal engagement supports the Maternal Care Bundle and Core20PLUS5 ambitions.
What we aim to achieve in 2026/27
We aim to increase the proportion of women from target groups booking by 9+6 weeks, reducing unwarranted variation and improving early access to appropriate maternity care.
This will be supported through community engagement, partnership working and targeted service improvement.
Key deliverables
- Analyse barriers to early booking in target populations by Q1
- Strengthen community outreach and referral pathways by Q2
- Improve timely access to screening and personalised care by Q3
- Demonstrate a reduction in late booking among target groups by Q4
Priority 6: NatSSIPs2 Implementation
Why we have chosen this as a quality priority
Implementing the National Safety Standards for Invasive Procedures 2 (NatSSIPs2) will strengthen patient safety and reduce the risk of avoidable harm associated with invasive procedures.
Following updated national guidance published in 2023, NatSSIPs2 places greater emphasis on organisational standards and consistent safety behaviours rather than checklist compliance alone.
What we aim to achieve in 2026/27
Variation in Local Safety Standards for Invasive Procedures (LocSSIPs) and limited digital integration present risks to patient safety. Continuing this programme for a second year will support safer care, learning and alignment across the Acute Provider Group.
We aim to harmonise and digitise LocSSIPs, improve compliance and assurance and strengthen consistency and safety across services.
Key deliverables
- Review and standardise Trust LocSSIPs by Q1
- Progress digitalisation and IT integration by Q2
- Strengthen assurance and compliance monitoring by Q3
- Demonstrate improved procedural safety outcomes by Q4
Priority 7: Paediatric Deteriorating Patients (NPEWS)
Why we have chosen this as a quality priority
Following implementation of the National Paediatric Early Warning Score (NPEWS), system-wide oversight is required to ensure it delivers improved recognition and response to deterioration.
This aligns with national patient safety initiatives, including Martha's Rule, and responds to learning from incidents, audits and Patient Safety Incident Response Framework (PSIRF) investigations.
What we aim to achieve in 2026/27
We aim to embed NPEWS consistently, strengthen escalation and response to deterioration and reduce unwarranted variation. Shared learning across North West London will support improved safety and outcomes for children.
Key deliverables
- Establish a North West London Paediatric Deteriorating Patient Group by Q1
- Monitor NPEWS compliance and clinical outcomes by Q2
- Review sepsis, escalation and Emergency Department triage alignment by Q3
- Use audit and PSIRF learning to demonstrate improvement by Q4