England's Chief Inspector of Hospitals has rated East Sussex Healthcare NHS Trust as Requires Improvement overall following its latest inspection by the Care Quality Commission.
The trust was placed in to special measures in September 2015 and, following its most recent inspection in October 2016, Sir Mike Richards has recommended it should remain in special measures for a further period of time.
While the trust is rated Requires Improvement overall, it is rated as Good for being caring and Requires Improvement for being safe, effective, responsive and well-led.
Inspectors found that, while further work was needed, a number of improvements had been made at Eastbourne District General Hospital and at Conquest Hospital in Hastings. Both had previously been rated Inadequate but, following the most recent inspection, both are now rated requires Improvement.
Since the previous inspection in March 2015 the trust had made significant improvements in its services. A new leadership team was in place, was very visible and the former concerns of bullying and lack of staff engagement appeared to have been tackled. The organisational culture had transformed with staff on the whole positive, well engaged and feeling valued by the organisation. But, inspectors found further improvement were required. Both of the trust’s Accident and Emergency departments were rated as requires improvement but with poor staffing levels, poor record keeping and deteriorating performance against access standards. The senior team is relatively new and some improvements had only recently been introduced and were not fully embedded for inspectors to take a measured view of the improvements
Professor Sir Mike Richards, the Chief Inspector of Hospitals, said:
“In the past year there have been significant changes to the senior management group at East Sussex Healthcare NHS Trust. The team has worked well together and, with the support from special measures and external partners, has addressed a number of the issues previously identified in our inspection last year including surgery improving from inadequate to good. However, the improvements identified are fairly recent and not fully embedded. Continuation of this improvement must be seen as a priority for the trust.
“While the trust continues to make substantial progress, I remain concerned that performance within the emergency department is not as robust as it could be, and this is having an impact on the quality and timeliness of services for patients. While I appreciate the issues surrounding staffing, there are still delays in patients being transferred from ambulances to the emergency department.
“I feel optimistic that the trust will continue to improve, but it will require continued support for the foreseeable future. Others with a responsibility for health services in the area need to help address problems the trust cannot deal with on its own. That is why I am recommending the trust remains in special measures.”
“Compared to CQC’s last inspection in March 2015 there was positivity about the changes in culture within in the organisation. The concerted efforts by the leadership group have helped develop some significant improvements particularly in staff engagement.
CQC saw several areas of outstanding practice at the trust including:
- There was positive engagement of staff in the outpatient department from management and a commitment to deliver high quality care and develop staff.
- The recent maternity review was effective and considered the views of users alongside staff. It resulted in quick improvements to the service and a more positive culture amongst staff.
- A dedicated multidisciplinary team had established a five year plan to establish an innovative rehabilitation care plan as part of an out of hospitals services transformation programme
- This programme included staff from multiple specialties and enabled ED staff to work with colleagues from across the trust, and in the community, to develop future services.
- Innovative service developments to meet the individual needs of specific patients were being encouraged. This included providing keepsake boxes for bereaved parents and including the use of knitted comfort bands to reduce the likelihood of patients with dementia tugging at intravenous lines.
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I feel optimistic that the trust will continue to improve, but it will require continued support for the foreseeable future.
Professor Sir Mike Richards, the Chief Inspector of Hospitals