The Chief Inspector of Hospitals has rated East Sussex Healthcare Trust, which runs Eastbourne DGH and Conquest Hospital, as ‘inadequate’ – for the second time in a year.
The Care Quality Commission (CQC) has also recommended the trust is placed in special measures and has called for it to address the “perceptions of a bullying culture”.
A report published today (September 22), reveals low staffing levels at the hospitals, clinics cancelled at short notice, breaches in requirements of single sex accommodation and “little consideration” for people’s privacy.
However inspectors rated care across the trust as “good”, finding patients were treated with “compassion, dignity and respect”.
Professor Sir Mike Richards, Chief Inspector of Hospitals, said: “It is clear from our most recent inspection that East Sussex Healthcare NHS Trust has been struggling to deal with deep-rooted problems which have been having an impact on its core services.
I am disappointed that the trust has made too little progress in dealing with the significant issues in the underlying culture which have been all too apparent for some time.Sir Mike Richards
“I am disappointed that the trust has made too little progress in dealing with the significant issues in the underlying culture which have been all too apparent for some time.
“While I recognise that the trust has been working over the last few months to make further improvements I am chiefly concerned at the rate of progress since our inspection last year.
“The continuing disconnect between the trust board and staff is worrying, and I am sure lies behind the continuing poor performance.
“I know there has been some improvement; I am aware of the renewed determination by the new senior managers to take more robust and focussed action.
“Despite these assurances, I do not feel the improvements we have seen are nearly enough to put to rest the concerns of the people who use the services or local stakeholders.
“Therefore I am recommending to the NHS Trust Development Authority that this trust should be placed into special measures, which will enable it to get the support it needs.
“We will continue to monitor the trust’s performance closely. I am hopeful that when we return in the future to check again – we will find evidence of significant changes for the benefit of all who those depend on its services.”
The trust was last inspected in September 2014, when Conquest Hospital and Eastbourne DGH were both rated “inadequate”.
A team of CQC inspectors followed this up with an unannounced inspection in March 2015 – looking at progress in maternity services, outpatient and diagnostic imaging services, surgery and accident and emergency care.
A spokesman for the CQC said: “During the inspection in March, CQC found that there was a widespread disconnect between the trust board and staff.
“Although the board recognised that staff engagement was an area of concern, there was no effective strategy to improve.
“Inspectors found that staff remained afraid to speak up or share concerns in case of repercussions.”
The committee which scrutinises the East Sussex Healthcare NHS Trust (ESHT) said it has “no confidence” in the trust’s leadership at a meeting in May.
Darren Grayson, former chief executive resigned in July, but chairman Stuart Welling has stayed at the trust.
The CQC added: “Low staffing levels were affecting the trust’s ability to deliver efficient care. Patients were not always being seen for follow up appointments within the timescales requested by their clinician and at times clinics were cancelled at short notice. Patients were not always being informed until they arrived for their appointment.
“The trust was frequently breaching requirements on the provision of single sex accommodation, but not identifying or reporting this.
“Women and men were both accommodated overnight in the clinical decisions unit and had to walk past people of the opposite sex to use toilets and washing facilities.
“There was little consideration for people’s privacy in the outpatient department and radiology, where changing and waiting facilities were unsuitable and where weighing and other procedures were carried out in corridors.
“Staff remained unconvinced of the benefits of incident reporting, and were not reporting incidents or near misses in a way that would lead to the trust improving services from that learning. While there had been some improvements in maternity and surgery, learning was still limited and lessons learned were not embedded.”
ESHT has been told it must make improvements in 12 areas, including rebuilding effective relationships with staff, creating an open culture where people feel they are able to speak out, addressing perceptions of a ‘bullying culture’, making sure the trust complies with national guidelines for cleanliness, keeping health records confidentially managed and making sure there are enough staff in maternity services.
The Care Quality Commission presented its findings to a quality summit on September 18, to develop a plan of action and recommendations based on the inspection team’s findings.
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