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East Sussex NHS CQC Report

Friday, March 27, 2015

GMB Expected Chief Inspector Of Hospitals Finding That East Sussex Healthcare NHS Trust Is Inadequate

Members are huge supporters of a properly functioning and efficient NHS and are only too keen to help if someone at the top has the foresight to ask for assistance says GMB

GMB, the union for staff at East Sussex Healthcare NHS Trust, responded to the finding of the Chief Inspector of Hospitals that East Sussex Healthcare NHS Trust is inadequate. See notes to editors for the Care Quality Commission press release dated 27th March.

In particular GMB commented on the following CQC recommendations:

·           That any rebuilding of the relationship with staff needs to be grounded in openness and to develop a culture where people feel free to speak out.

·           That the Trust undertakes a review across the organisation to address perceptions of a bullying culture, and to improve relationships with all stakeholders and the population it serves, specifically in relation to their concerns about service reconfiguration.

·           That a review of staffing levels is required to ensure they are sufficient for service provision within the trust.

Gary Palmer, GMB Regional Organiser, said “GMB had no doubt that the CQC findings would finally highlight poor leadership an communication and lack of engagement with both staff and the public in its damning report.

The report makes clear that staff feel disengaged and undervalued and have had to work in a culture where they have been made to feel afraid to speak out or to share their concerns. It also mentions that the unilaterally imposed reconfigurations had led to services deteriorating and had left them unable to respond to the needs of those using the service.

GMB and staff at the Trust have always stated that it was vital for the right leadership to be in place and our criticism of the direction taken by the leadership has been vindicated.

Darren Grayson, Chief Executive hired a Turnaround Director at a cost of over £500,000, who then spent hundreds of thousands of pounds more bringing in further so called experts, to forcefully redeploy staff, close, mothball or relocate wards and reconfigure services between the hospitals and community. They have only managed to deliver inadequate outcomes condemned by the CQC inspection in September 2014. They have let down staff working in the Trust, together with the patients and public of the south east.

Something has to change.

GMB members have told us that the report and outcomes suggests to them that possibly a change at the top is needed as all the enforced changes by the expensive experts elsewhere within the Trust have not improved things at all, but in fact simply increased the failures.

The engagement of GMB members and staff who work in both the hospitals and community services at the Trust is required as they have the knowledge and expertise to turn this around.

GMB members are huge supporters of a properly functioning and efficient NHS. We are only too keen to help if someone at the top has the foresight to appropiately ask us for assistance.

If the Trust engage with us openly and meaningfully it is GMB members and staff who will improve, not only the service provision at the Trust to a point of gaining a better CQC rating, but also to make efficiency savings without seeing services or patients safety put at risk and without having to see the need to cut the terms and conditions for members of staff at the Trust to save money.” 

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Contact: Gary Palmer GMB Organiser 07552165950, Mark Turner GMB Branch Secretary 07860787973 or Charles Harrity, GMB Senior Organiser on 07977518042 or GMB press office 07921 289880 or 07974 251 823

Notes to Editors

CQC press release - published 27 March 2015

Chief Inspector of Hospitals finds that East Sussex Healthcare NHS Trust is Inadequate

England's Chief Inspector of Hospitals, Professor Sir Mike Richards, has published his first report on the quality of services provided by East Sussex Healthcare NHS Trust.

Overall the trust has been rated as Inadequate.

The inspection took place in September 2014. Because of the longer than usual time between the end of the inspection and publication of the report CQC inspectors returned to the trust on 24 March to assess the progress the trust has made addressing the serious concerns we raised.

In most cases, a rating of Inadequate would lead to the Chief Inspector of Hospitals recommending that the trust be put in special measures. Early indications from this week’s inspection, which focused on those services that were judged in September to cause the greatest concern – maternity, surgery and outpatients – are that improvements have been made, although inspectors still have concerns about the leadership and culture of the trust. As a result, any decision on special measures will be deferred until he has considered in full the findings of the latest inspection.

The Chief Inspector of Hospitals, Professor Sir Mike Richards, said:

“When we inspected East Sussex Healthcare NHS Trust in September, we were extremely concerned at the disconnect we identified between the senior team and the staff working on the frontline. We saw no sign of a clear vision and strategy and a lack of response to concerns raised by staff. We had specific serious concerns about maternity, surgery and outpatients.

“Our recent inspection indicates there have been improvements in important areas for patients, but I am still concerned about cultural and leadership issues at the trust. I will not be making a judgment about special measures until we have fully assessed the results of our most recent inspection.

“We, alongside our partners will continue to keep a close eye on the trust and will inspect again in due course to assess whether or not adequate progress is being made.”

During the inspection in September a team of inspectors and specialists including doctors, nurses, managers and experts by experience visited Eastbourne District General Hospital and Conquest Hospital at Hastings. The trust’s community healthcare services for children and young people were also inspected.

CQC rates trusts on five key questions that reflect the care that patients have a right to expect. East Sussex Healthcare was rated Inadequate for ‘Safe’ and ‘Well led’, ‘Requires Improvement’ for ‘Effective’ and ‘Responsive’ and ‘Good’ for ‘Caring’

The regulator also rates the individual hospitals run by the trust and the core services they provide. Overall inspectors rated Conquest hospital as Inadequate, although medical and critical care were rated as Good. Improvements were required for accident and emergency, children’s services and end of life care. Surgery and maternity were both rated as Inadequate.

Eastbourne District General Hospital was rated Inadequate overall, although critical care was rated Good. Surgery and Outpatients were both rated as Inadequate and accident and emergency, medical care, children’s services and end of life care requiring improvement. Full reports are available at www.cqc.org.uk/provider/RXC.

Our inspectors found that there was a worrying disconnect between the trust’s most senior managers and frontline staff. Staff were concerned about how change was implemented, low morale, bullying and harassment and a number of staff came forward to raise serious concerns with CQC about the culture of the trust and the care being delivered.

At Conquest Hospital, inspectors found that although maternity staff were caring, the service was poorly managed with inadequate staffing. Staff were working long hours without breaks and with little support and this was reflected by a high level of absence through sickness. Managers were trying to maintain a good service under trying circumstances.

Inspectors found every service to be caring and compassionate, with staff at all levels committed to providing good patient care and frustrated when they felt they could not achieve this. Patients commented positively about the staff providing the care

The inspection team identified ten areas for improvement including:

The trust must improve the relationship with its staff, specifically the culture of the organisation, so that people feel able to speak up.

There must be a review of the culture within the organisation especially the perceived allegations of bullying.

The trust must work to improve relationships with the population it serves; specifically relating to their concerns about service changes, including the changes to the maternity services.

The way medicines are managed in clinical areas must be improved.

Changes within the outpatient services must be reviewed to ensure that they meet the needs of patients.

Waiting times for outpatient appointments must be reviewed to meet the government’s referral to treatment waiting times.

Ensuring there are sufficient staff to meet the needs of the service.

Overall, inspectors identified several areas of outstanding practice, including:

Clinical leadership and consultant presence in critical care.

The introduction of a handheld electronic system for recording patients‘ observations

Nurse-led discharge - an effective and efficient approach to patient discharge

Ends

For media enquiries, contact John Scott, regional engagement manager, on 077898 75809 or contact CQC’s press office on 020 7448 9401, during office hours, or, out of hours, on 0778 987 6508.

For general enquiries, call 03000 61 61 61.

Last updated:

27 March 2015

Notes to editors

East Sussex Healthcare NHS Trust (ESHT) provides acute hospital and community health services for people living in East Sussex and the surrounding areas. The trust serves a population of 525,000 people and is one of the largest organisations in the county.

The trust was inspected by CQC in September under its new inspection regime. The inspection team included doctors, nurses, hospital managers, trained members of the public, a variety of specialists, CQC inspectors and analysts. Inspectors also returned unannounced.

The Chief Inspector of Hospitals, Professor Sir Mike Richards, is leading significantly larger inspection teams than before, headed up by clinical and other experts including trained members of the public.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.

 

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