Background to this inspection
Updated
6 March 2020
Mid Essex Hospital Services NHS Trust was established in 1992 and continues to provide local elective and emergency acute medical services for adults and children for over 380,000 people living in and around Chelmsford, Maldon, Braintree and Witham. The trust also includes Braintree Community Hospital which covers the whole of Mid Essex and includes a variety of services including x-rays, MRI scans, CT scans, ultrasound, day surgery, endoscopies, physiotherapy, nursing and rehabilitation services.
The trust employs over 5,000 staff and had a total turnover of £317m in 2018/19.
The trust continues to focus on performance and financial improvements, supported by NHS Intelligence, NHS England and the CCG, to deliver their vision of becoming a financially stable, modern health system that delivers integration and excellence in local and specialist services.
Mid Essex Hospitals NHS Trust remains a non-foundation trust. The trust began working closely with Southend University Hospital NHS Foundation Trust and Basildon and Thurrock Hospitals NHS Foundation trust in 2014. In 2015 the Essex Success Regime was announced and collaborative working to have a joint clinical strategy began and continues. The leadership team’s restructure of the three trusts commenced in 2016 and was formalised as of 1 January 2017, shared governance arrangements began in March 2017.
This vision will continue through the proposed merger in 2020 of Mid Essex Hospital Services NHS Trust with Basildon and Thurrock University Hospitals NHS Foundation Trust, and Southend University Hospital NHS Foundation Trust.
Due to the pending merger of the three trusts in April 2020 of; Mid Essex Hospital Services NHS Trust with Basildon and Thurrock University Hospitals NHS Foundation Trust, and Southend University Hospital NHS Foundation Trust. The decision was made to inspect core services at Southend University Hospital NHS Foundation Trust and Mid Essex Hospital Services NHS Trust at the same time which meant the executive team would be interviewed once at the well led part of the inspection.
We last carried out an inspection at Mid Essex Hospital Services NHS Trust December 2018. One core service was rated outstanding, three core services were rated good, five core services were rated requires improvement and one core service was rated inadequate. The trust was rated as requires improvement for safe, effective, responsive and well led which resulted in an overall trust rating of requires improvement.
Updated
6 March 2020
Our rating of the trust stayed the same. We rated it as requires improvement because:
- We found that there were regulatory breaches resulting in requirement notices and found that the organisation was performing at a level which led to the overall rating as requires improvement.
- Overall, we rated safe and responsive as requires improvement, effective, caring and well-led as good. The overall rating remained the same. In rating this trust we took into account the current ratings of the service not inspected on this occasion.
- We rated two (urgent and emergency care and surgery) of the six core services inspected as requires improvement and four services (medical care, maternity, gynaecology and outpatients) as good. The well-led part of the inspection was rated as good. We previously rated maternity alongside gynaecology, therefore we cannot compare the new ratings with previous ratings. In our current methodology gynaecology is not aggregated in the overall ratings. Rating the trust overall, we took into account the three core service not inspected this time.
- The trust did not always have enough staff to care for patients and keep them safe. Not all staff had received training in key skills. Staff did not always fully document risk assessments of patients. Staff were not always managing medicines well.
- Staff provided good care and treatment, gave patients enough to eat and drink, and gave them pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services in the trust were available seven days a week.
- Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
- The trust did not always meet people’s needs. Patients could not always access treatments in a timely manner in line with national standards. The trust was underperforming for a range of specialties to meet the national standards for the national 18 week referral to treatment times and 62 day cancer waits to treatment. The trust planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback.
- Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The trust engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually. The trust was not externally reporting due to data validation issues.