Care Quality Commission (CQC) downgrades local NHS Trust, but care remains “outstanding”
On Friday 12th May the Care Quality Commission (CQC) published its long-awaited report into University Hospitals Sussex NHS Foundation Trust (UHSx).
The report follows an inspection carried out seven months ago which focussed on how well-led the Trust is, which examined the leadership, management and governance of the organisation making sure it is providing high-quality care that’s based around individual needs, that it encourages learning and innovation, and that it promotes an open and fair culture. CQC has rated the Trust as “requires improvement”.
The way in which CQC inspections operate means that this latest rating has also lowered the overall rating for the Trust to “requires improvement.” This means the Trust is not considered by CQC to be performing as well as it should and that it must improve.
Ratings in the CQC report
The report provided the following individual ratings to 5 of the 7 hospitals operated by the UHSx Trust across Sussex:
- Royal Sussex County Hospital RSCH, (Brighton) rated as “inadequate”. This means that the CQC believes the service is performing badly.
- Princess Royal Hospital (PRH, Haywards Heath) rated as “requires improvement”.
- St Richards Hospital (Chichester) rated as “outstanding”.
- Southlands Hospital (Shoreham) rated as “good”.
- Worthing Hospital rated as “outstanding”.
The report follows on from earlier CQC inspections into surgery at RSCH (which were rated as “inadequate” in December 2022), maternity services at RSCH and PRH (rated as “inadequate” in July 2022), and the Emergency Department at RSCH (rated as “requires improvement” in July 2022) and PRH (rated as good in August 2021). Prior to this latest report, the Trust had previously had an “outstanding” rating although it is important to note that this rating was carried over following the merger of Brighton University Sussex Hospitals Trust (formerly rated as “good”) and Western Sussex Hospitals NHS Trust (formerly rated as “outstanding”) in 2021.
Healthwatch in Sussex response
Healthwatch in Sussex have commented:
“This latest CQC rating is clearly disappointing for patients but also all staff who work incredibly hard to ensure that patients receive excellent care. Of particular concern is that services at the Royal Sussex County are not considered to be safe although patients should be reassured that the care offered across the Trust has been rated as “outstanding”. Healthwatch works closely with the senior management team at the Trust and have been reassured by the actions that they have already been put in place to deliver the required improvements. We need to continue to support our Trust as it continues its recover from COVID-19 and embeds change to deliver improvements and Healthwatch will be there to support them and offer critical challenge and champion the patient voice and experience.”
The latest rating for well-led is based on the views of 180 staff members who bravely came forward to share their views about leadership at the Trust. In December, just 49% of staff felt confident about being able to speak out but by March this year this had risen to 58% following action taken by the Trust.
The inspection follows the merger of two Trusts in 2021 to form the 7th largest acute Trust in the county, during the COVID-19 pandemic. The series of poor ratings since 2021 clearly reflect the substantial change that is still needed and also that recovery from COVID-19 is ongoing.
Since these series of CQC visits, Healthwatch is aware that the Trust has already recruited staff to the key areas of maternity and surgery, carried out external independent reviews of it surgical services, effectively reduced the list of longest waiters, reduced ambulance handover times, met national targets for cancer diagnoses, announced a planned £30million investment into the existing Emergency Department and will soon be opening the new multi million-pound Louisa Martindale building in Brighton. This year, the Trust received excellent results in a national maternity survey, ranking it 9th out of 121 trusts for good patient experience.
The CQC reported the following positive findings:
- That the Trust has a clear improvement strategy
- That senior leaders hold relevant experience, capacity and capability
- That the Trust regularly receives praise from patients and high scores from surveys
The CQC report found identified the following concerns
- That the leadership team are now clearly visible
- That support for staff needs to be improved
- That staff need to be supported to speak up