Emergency department at Sussex hospital slammed in inspection report

The Care Quality Commission (CQC) has released an updated report on its recent inspection of various departments at the University Hospitals Sussex NHS Foundation Trust. Whilst some departments have seen some improvement in recent times, other areas still leave more work to be desired. In April, the CQC inspected maternity services at four of the trust’s hospitals: Worthing Hospital, St Richard’s Hospital, Princess Royal Hospital and Royal Sussex County Hospital.

They also inspected the surgery and the emergency departments at the Royal Sussex County Hospital due to previous concerns. Warning notices had previously been implemented across the maternity departments of these hospitals but the CQC has since said that the trust has done enough improvements to meet these notices. However, the CQC has said that more work must be done at Royal Sussex County Hospital to improve its surgery and emergency departments.

READ MORE: The East and West Sussex parks named in Green Flag Awards as among UK’s best During its inspection of Royal Sussex County Hospital the CQC found that some patients requiring emergency surgery experienced delays and cancellations placing them at further risk. Staff also felt there was a reluctance to cancel elective surgery which could have allowed for more emergency surgery.

There was also deemed to be a lack of appropriately skilled nursing and support staff able to keep patients safe from avoidable harm and implement the correct care and treatment. Theatres and recovery wards also lacked nursing and support staff with appropriate skills – the staff in the theatres, who said they did not feel feel respected, supported and valued, spoke of poor staffing and exhaustion – something the CQC had witnessed during their previous inspection. In emergency departments at the hospital, patients were often accommodated in non-clinical areas such as corridors which meant their privacy and dignity was not always protected – confidential conversations between staff and patients could be heard by other patients.

Short stay areas were also unable to provide effective care for patients accommodated there, including those with mental illnesses, whilst there were challenges accessing the service due poor patient flow. Ambulance handovers were delayed, an increasing number of patients were staying longer than four hours before leaving and an increasing number of patients were in the department for more than 12 hours after being admitted. Safety information was collected by staff but was not always accurate.

However, in Royal Sussex County Hospital’s maternity wards, staff investigated poor outcomes as a method of learning whilst doctors, nurses and other healthcare workers used teamwork to provide good care. Women were also treated with compassion and kindness and their needs were taken into account whilst emotional support was also offered to family and carers.

Royal Sussex County Hospital's emergency department is one area that was inspectedRoyal Sussex County Hospital’s emergency department is one area that was inspected

Staff said they felt valued by team members and felt there was a collaborative relationship between medical and midwifery departments. Surgery staff were deemed to be focused on patient’s needs and the surgery team as a whole engaged with the community to plan and manage services.

Across maternity departments at all four inspected hospitals it was noted that new midwives had been employed to ensure safer staffing levels for women and babies. Improvements have also been made to allow for the completion of mandatory training – something staff had previously been unable to do. Those women attending a triage service were now being seen based on risk instead of in a subjective way.

Midwifery leaders at three of the hospitals were seen to be able and visible to lead the service offered – at Princess Royal Hospital this was less noticeable. Carolyn Jenkinson, CQC head of hospital inspection, said: “At this inspection we saw a number of improvements at University Hospitals Sussex NHS Foundation Trust’s maternity department. The trust still have work to do, but it is positive that so much progress has been made, and we’ll continue to monitor them to make sure these are embedded and built upon.

“We are concerned however, that very little improvement had taken place in surgery at the trust since our last inspection. Leaders understood the issues that service faced but weren’t always able to manage them. Staff didn’t feel supported and it was worrying that those without the necessary skills, competence and training were caring for patients.

“We also found the number of cancellations for emergency surgery worrying. There was a lack of oversight around complications for patients associated with delays and cancellations of emergency surgery. Medical staff we spoke with told us that the management of these wasn’t good enough, meetings were often cancelled and poorly attended – this is something we need the trust to resolve as a matter of urgency and with that in mind we have now imposed conditions upon the registration of the trust to ensure immediate and significant improvements are forthcoming. “

As the inspection on maternity and surgery departments was only a check up on progress, they continue to be rated as inadequate at this time. The rating for the emergency department at Royal Sussex County Hospital has moved from good to requires improvement after this new inspection. Do you want the latest news from across Sussex delivered straight to your inbox? Click here to subscribe to our newsletter

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