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10 August 2017, 10:24
The Care Quality Commission has found significant improvements in services provided by Brighton and Sussex University Hospitals NHS Trust.
CQC inspectors visited the Princess Royal Hospital at Haywards Heath, and the Royal Sussex County Hospital in Brighton In April to review the progress made by the trust since its last inspection.
In April 2016 the trust had been rated Inadequate and placed into special measures. As a result of this latest inspection, the trust's overall rating has now been revised to Requires Improvement. CQC is recommending that the trust should remain in special measures for a further period.
Immediately prior to the inspection management responsibility for the trust passed to the board of Western Sussex Hospitals Foundation Trust.
Inspectors found there were areas of improvement in most areas which had been identified at the previous inspection.
At Royal Sussex County Hospital CQC found that staff had clearly striven to deliver improvements dignity and privacy within the outpatients department, although the environment within the eye clinic still presented difficulties in delivering care in a confidential and dignified manner.
Previously staffing levels and the skill mix in emergency departments, medical wards, critical care and midwifery were found to be too low to ensure patients received the care they needed. Although there were more doctors in the emergency department staffing levels and recruitment still remained a challenge.
The trust has tried to address an organisational culture of bullying and harassment via leadership training and a staff initiative with a campaign backed by staff communications, and new guidance and tools.
Within the emergency department there was a new self-rostering approach to medical cover that had a significant impact on the department. This initiative allowed the department to provide round the clock medical cover without the use of temporary staff.
The introduction of a clinical fellows programme in the emergency department had improved junior doctor cover and allowed better development opportunities for juniors.
CQC has told the trust it must ensure patients' dignity and privacy is respected in the emergency department by ensuring there is enough space in holding bays, with proper screening and by avoiding the use of mixed sex accommodation.
At Princess Royal Hospital consultant cover had increased although there were still concerns regarding the provision of paediatric nursing and paediatric anaesthetist cover to the emergency department.
Inspectors found the care of patients living with dementia was well developed on Hurstpierpoint Ward. Staff told inspectors that there had been an improvement in the management of poor behaviour, notably in the maternity department where a new code of conduct had been introduced.
CQC has told the trust it must review the current paediatric service in the emergency department and ensure there are enough staff to safely meet children and young people's needs.
The Chief Inspector of Hospitals, Professor Ted Baker, said:
"I am well aware that our inspection of Brighton and Sussex University Hospitals NHS Trust coincided with the introduction of significant changes to the senior management which I hope will help the trust deal with the underlying problems we have found in the past.
"I am pleased to note that we have already found real improvements have been made since our last inspection. All those involved in the delivery of that change should be given the credit for that work.
"However there still remains an extensive programme of change to be delivered and embedded.
"There is no doubt that the lack of consistent leadership has hampered the pace of change in the last 12 months. I am hopeful that the new joint working with Western Sussex Hospitals will provide a period of stability and clarity of leadership that will lead to sustainable change.
"For now I recommend that the trust remains in special measures. We will return in due course to check on further progress."
Marianne Griffiths, Chief Executive of BSUH, said:
“The inspectors’ findings recognise the tremendous efforts made by staff across the Trust over the past year. It is a credit to all staff, who have worked to make sure we provide better care to our patients.
“It is no surprise to me that the inspectors rated the quality of care across all our services as ‘good’. Many of the other issues identified are due to systems that don’t work properly, or buildings that are no longer fit for purpose. But we have got the quality where it counts – in our people.”
The new executive team arrived in April, just days before the inspectors. The CQC report identifies a lack of consistent leadership as a reason further progress wasn’t made up to April 2017 and looks forward to the improvements that can be achieved during a period of stable leadership.
Marianne Griffiths continued:
“We’re transforming our hospitals through a massive building programme which will bring some of the oldest buildings in the NHS into the 21st century. At the same time, we’re working to a programme that will deal with the issues identified by the CQC, ensuring we provide excellent care, create a positive culture across the Trust and continuously improve.”