Croydon's NHS Trust has made "significant" progress but still requires improvement, the health watchdog has said.

The Care Quality Commission (CQC) highlighted 13 areas of "outstanding practice" at Croydon Health Services, although its report, published today, also flagged up concerns about staff vacancy rates and cancelled operations.

Inspectors spent several days at Croydon University Hospital and Purley War Memorial in June, after the CQC assessed Croydon as "high risk" and prioritised it for assessment earlier this year.

They rated Croydon Health Services as "requires improvement" overall - the first rating the trust has been given since the watchdog launched a new tougher regime of inspection in 2013.

Prof Sir Mike Richards, the CQC's chief hospitals inspector, said: "Croydon Health Services NHS Trust has made significant improvements across a number of services in relation to patients being able to access care and treatment in line with national standards.

"Good progress has been particularly made in developing both the inpatient and community health services to meet the specific needs of the local population, particularly for vulnerable people.

"Patients and families we spoke with told us they received compassionate care and were treated with dignity and respect."

The trust's specialist palliative care team, special baby care unit and community nursing team were among the areas described as "outstanding."

But Prof Sir Richards added: "Despite this, the trust continues to face challenges in many other areas, including community services, surgery and critical care. 

"Operations were sometimes cancelled, the day surgery department experienced difficulty in coping with the increased level of demand and patients were often delayed when being discharged from critical care.

"We were concerned that vacancies across all staff groups remained an ongoing issue, resulting in the regular use of locum and bank and agency staff to maintain safe staffing levels."

Inspectors also found some staff sometimes did not report untoward incidents and those that were reported were not always learned from.

John Goulston, the trust's chief executive, said: "The majority of the improvements are within our hands, such as increasing the number of staff who complete mandatory refresher training every year, and further strengthening our governance process throughout the Trust.

"I am extremely proud that the CQC has recognised the considerable achievements of our dedicated and caring staff.  Thanks to them we have made several leaps forward, but we know there are aspects of our services where we can, and must, do better."

In a lengthy response to the report, the trust outlined its plans to implement improvements ordered by the CQC.

It is to overhaul its surgical theatres, invest in new IT systems and expand its staff recruitment campaign.

Mike Bell, trust chairman, said he was "proud" of the progress it had made since 2013, when CQC inspectors said it required "significant improvement".

He added: "Our CQC inspection two years ago was the single most important advice that we could have been given to focus our attention on what we needed to improve.  T

"This relentless focus must now not slip, and we must maintain these improvements."

Surgical theatres overhaul

Croydon Health Services (CHS) is to "completely refurbish" all nine of the surgical theatres at Croydon University Hospital following criticism in the CQC's report.

The watchdog told the trust to implement "prompt plans" to revamp the theatres and replace ageing equipment, used to perform more than 30,000 operations a year.

Work on the refurbishment will begin next year with theatres renovated two at a time to avoid impacting on waiting times, the trust said.

CHS has spent more than £1m on new theatre equipment over the last 15 months, including £130,000 on anaesthetic machines more than £90,000 on operating tables.

The hospital will also introduce a new scheduling system so more operations now start on time and will make "more efficient" use of its theatres to reduce waiting lists.