Frank le Duc: The Vote
Brighton hospital bosses are preparing for a formal inspection next month on the back of challenging feedback
Inspectors from the Care Quality Commission (CQC) are due to visit the Royal Sussex County Hospital in Brighton next month. Their inspection comes hot on the heels of a report published in the past fortnight after a “listening exercise”. And it comes shortly after the results of the annual NHS staff survey were published.
The trust which runs the Royal Sussex – the Brighton and Sussex University Hospitals NHS Trust – is a big organisation. It would be unrealistic to expect a perfect scorecard. In a letter to staff last week the trust’s chief executive Matthew Kershaw wrote about the good and the bad in the latest CQC report.
Mr Kershaw said: “The report contains some real positives, not least that the all patients they spoke to were complementary about the quality of their care.
It did though also highlight some real challenges and one of the recurring themes is, in their words, tensions among staff and issues relating to the behaviours of individual staff members.
“We were able to say in response to this particular issue that we are well aware we have some longstanding, difficult and complex cultural issues to address and a great deal of work is already under way to do so – one of the main elements being our values and behaviours project which has been progressing at full speed since the beginning of the year.
“These are words on a page until we build a plan to ensure they are highly visible, embedded in the way we operate, that the necessary support is in place to enable people to live by them and to ensure when people don’t we take appropriate action. Which is why an implementation plan setting out how we will do this is also being developed, alongside the behavioural blueprint, and both will be published at the beginning of May.”
At the most recent meeting of the trust board, the directors were presented with the results of the annual staff survey. It suggested that bullying and harassment was regarded as less of a problem than a year ago. It also found that nine in ten staff felt that their role made a difference to patients and the same number felt satisfied with the quality of care that they were giving.
On the downside three in four staff felt that there were too few staff. Two in three felt that communication with senior managers was poor. Two in three also felt that the job was bad for their health and that they had no support for their health and wellbeing. And more than half of those responding said that they went to work even when they felt ill.
The board was also addressed by one of the hospital’s accident and emergency (A&E) consultants Rob Galloway. He said that one of his heroes, Professor Doug Chamberlain, a long-serving cardiac surgeon at the Royal Sussex, had said that if you wanted to sound intelligent, quote Osler. He was referring to the father of modern medicine Sir William Osler.
“The very first step towards success in any occupation is to become interested in it”
Dr Galloway cited Osler’s advice that “the very first step towards success in any occupation is to become interested in it”. The board meetings have grown longer in the past few years. The board appears to be taking a closer interest in more aspects of the hospital and the wider trust. There has been, for example, a relentless focus on infection control. As a result the number of cases of the hospital superbug MRSA and clostridium difficile, also known as C diff, have declined markedly. This is good news for patients.
Even a superficial glance at the wisdom imparted by Osler suggests plenty of other guidance for the same audience. And the medically qualified members of the board are almost certainly mindful that Osler’s sign is an artificially high blood pressure reading due to a hardening of the arteries. The promise of improved communication with staff – and presumable patients and the public – can only help ease some of the pressure. The forthcoming CQC report will provide a vital indication.
