Brighton hospital improving - but remains in special measures

Royal Sussex County Hospital, Brighton (Photograph: Eddie Mitchell)
Royal Sussex County Hospital, Brighton (Photograph: Eddie Mitchell)

The NHS trust running Brighton’s hospital has made ‘significant improvements’, according to the health watchdog which placed it into special measures last year.

The Care Quality Commission (CQC) visited the Royal Sussex County Hospital in Brighton - and the Princess Royal Hospital at Haywards Heath - to review progress made by the trust.

Marianne Griffiths, the chief executive of BSUH

Marianne Griffiths, the chief executive of BSUH

It found that the Royal Sussex County Hospital was ‘good’ for caring, ‘requires improvement’ for effectiveness, responsiveness and leadership, but it was ‘inadequate’ for safety - the lowest rating the CQC can give.

It said staff at Brighton had ‘clearly striven to deliver improvements’ and that a culture of bullying and harassment is being addressed.

But inspectors also found that staffing levels in many areas were still too low, although there were more doctors in the emergency department.

The CQC said at busy times, patients were still being held in the corridor area of the emergency department.

It also said there was no ‘over-arching strategy’ for the maintenance of a clean environment, and that some areas of the hospital were in ‘poor condition’.

The inspection comes one year after the watchdog found the hospital - and the trust which runs it - to be ‘inadequate’.

That rating has now been changed to ‘requires improvement’, one step up from inadequate, but inspectors recommended the trust should remain in special measures.

The inspectors did note that the timing of their latest inspection in April was just before management responsibility for the Brighton and Sussex University Hospitals NHS Trust (BSUH) passed to the board of Western Sussex Hospitals Foundation Trust, which runs hospitals in Worthing and Chichester, and is rated ‘outstanding’.

Marianne Griffiths, the new 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.

“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.”

Professor Ted Baker, the chief inspector of hospitals, said: “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.”

What the report said

The report, which focused on a CQC visit from April 25 to 27, looked only at areas which were a cause for concern in the last inspection. These were: emergency care, medical services, surgery, critical care, maternity and gynaecology and outpatients and diagnostics.

Services for children and young people and end of life care were not inspected as they were rated outstanding and good respectively in the last inspection.

Inspectors found that medical care, surgery and outpatients all remain ‘requires improvement’. The CQC said in surgery that two ‘never events’ had taken place in the last year, the theatre department did not comply with health and safety regulations, and there were concerns about cleanliness audits not being carried out properly.

Urgent and emergency services went from inadequate to requires improvement, as there were improvements to patient safety and maintaining the dignity and respect of patients. Inspectors also found ‘strengthened senior leadership’ and an improved culture. But it did say the environment was ‘not fit for purpose’ as the capacity of the department did not meet the demand. Staffing levels remained a concern.

Critical care remained ‘inadequate’, as there was a large incident backlog, patient records were not always secure, and incidents relating to medication errors were high with no investigation, not all staff complied with the ‘bare below the elbows’ policy when delivering direct patient care, and some other infection risks were not recognised.

Maternity went from ‘requires improvement’ to good, as there was better reporting of incidents, more consultants and a clear strategic direction for the department.

To read the report in full, click here.