Regulator raises concerns with Brighton hospital bosses

The Care Quality Commission (CQC) has published a report after carrying out three visits to Brighton and Hove’s main hospital trust.

The CQC, which is the official regulator for hospitals and care homes, will be returning to Brighton next month to carry out a formal inspection.

It described the report published yesterday (Wednesday 2 April) as the result of a listening exercise involving Brighton and Sussex University Hospitals NHS Trust staff and patients.

The report follows three visits, including one when the CQC chairman David Prior visited the Royal Sussex County Hospital in January.

His visit was in response to concerns raised by the NHS Black and Minority Ethnic (BME) Network.

The CQC said: “A number of concerns had been raised by senior staff within the trust, individuals who did not want to be identified and also specific concerns raised by the National Health Service Black and Minority Ethnic Network (NHS BME Network).

“The NHS BME Network is a national network of NHS staff whose purpose is to be the ‘independent and effective voice for BME staff, BME patients and BME service users to ensure the NHS delivers on its statutory duties regarding race equality’.

Patient safety

“Due to the complexities of the concerns that were raised with (the) CQC, we considered that further information was needed to ascertain the potential impact that those concerns may have had on patient safety and patient experiences.

“We have sought assurances from the trust where the information may have resulted in the potential risk of harm to patients that action has been taken.

“We will continue to monitor the actions the trust has taken between now and the inspection in May 2014.”

Those taking part in the listening events in December and January included Professor Sir Mike Richards, the chief inspector of hospitals.

The CQC team met patients, staff and members of the public who either worked in or attended the Accident and Emergency Department, medical wards and the cardiac, maternity and renal units at the Royal Sussex County Hospital.

Staff were also given an email address so that they could raise concerns in confidence.

The CQC report said: “Many staff we spoke with from across the trust were positive about the team they worked with and the standard of care they delivered.

“There was a focus on patient safety with access for staff to report concerns and incidents.

Feedback

“The feedback from staff was that learning from incidents, accidents and complaints was not always shared to help prevent future occurrences.

“Patients consistently spoke positively about the care and treatment they received.

“We were told about various projects and initiatives that had been introduced to help enhance the patient journey, specifically within the Emergency Department and on the Care of the Elderly Ward where we were told a dementia nurse specialist had been appointed.

“A number of patients felt that there were not always enough staff on the Maternity Unit which resulted in staff appearing rushed.

“Patients felt that their individual needs may not have always been met as a result.

“Some staff were concerned that there was a lack of cohesive working between members of the multidisciplinary teams which had the potential to affect the patient experience.

“We found there were concerns about insufficient numbers of staff such as junior doctors and occupational therapists in some areas.

“Managers told us that the process to fill vacant positions was slow and often resulted in staff not being appointed due to delays in processing job offers.

Progress

“Staff we spoke with across the trust gave a mixed view of supervision and appraisal with some reporting supervision was not regular and some had received no supervision or appraisal.

“While significant progress had been made to address this, staff reported ongoing problems in accessing training.

“We received variable feedback from staff members regarding the support provided by their direct line managers.

“Some staff spoke positively about the support they received while others spoke negatively stating that their departmental management hierarchy had become ineffectual.

“Staff told us about the continued challenges of working in some environments that were outdated and no longer fit for purpose.

“For example, there was a lack of equipment storage space on a number of wards and poor connections between the various outbuildings on the Royal Sussex County Hospital campus which resulted in patients experiencing long transfers.

“The trust told us of the plans for the 3Ts major redevelopment for some of its sites.

Decision expected

“A funding decision is expected from the Treasury in the near future.

“Other building work is planned and will continue as part of the estates and facilities work programme.

“Where we had received information of concern from staff before, during and after our visit, we have maintained their confidentiality.

“This has included information regarding the professional conduct and behaviours of individual staff members.

“We have passed the information to the chief executive to investigate and report back to us on the findings so that any potential patient safety concerns could be identified and appropriate actions put in place to reduce the risk of potential harm.

“He is keeping us informed of the progress.

“During and after our visits staff told us that there were significant tensions among staff.

“This was in particular for staff from black minority ethnic (BME) groups who told us they felt disadvantaged and at times subject to racially motivated bullying and harassment.

“Some of these concerns had previously been raised with the trust directly who were able to provide us with confirmation of the actions they have taken to address those concerns.”

To read the report, click here.