Brighton hospital chief says inadequate A&E rating reflects wider problems across local health economy

The chief executive of the Royal Sussex County Hospital in Brighton has defended accident and emergency staff after official inspectors rated A&E responsiveness as inadequate.

Matthew Kershaw, chief executive of Brighton and Sussex University Hospitals NHS Trust, which runs the Royal Sussex, spoke after the Care Quality Commission (CQC) published its verdict on Friday (8 August).

Mr Kershaw said: “The area of challenge which is the most complex and requires the most attention is the inadequate rating we were given for A&E responsiveness at the Royal Sussex County Hospital.

“I want to be very clear that this is not because our Emergency Department is inadequate or failing, a clarification which the CQC absolutely endorsed.

The Royal Sussex County Hospital in Brighton

“What this rating reflects is that the whole system – which includes in-hospital care, the numbers and types of people who come into A&E and the discharge of people who no longer need to be in hospital – is not working consistently as well as it should.

“There are lots of elements of this we need to do better and we have been working very hard on these for some time and are making progress.

“But this is not an issue we can solve in isolation.

“The flow of patients into, through and out of the hospital is as much about the health and social care services and support provided in the community as what happens in the hospital itself and those responsible are working positively with us to increase and improve these services as a real priority.”

The CQC published a set of reports after inspecting the trust, the Royal Sussex, the Princess Royal Hospital in Haywards Heath and various other sites including Hove Polyclinic.

The CQC found that all the services that they inspected across the trust were caring and effective and that staff communicated with and supported people in a compassionate way.

The inpsectors also found that, although improvements were still needed, a significant amount of progress had been made in the six months since their last visit.

They mentioned the work being done to address the long-standing cultural issues within the trust.

They said that there had been impressively rapid progress on working with staff to develop a new set of organisation-wide values and behaviours. And during their inspection they found impressively universal awareness of these.

The CQC’s head of hospital inspection Mary Cridge, who led the inspection team, said: “I would like to acknowledge how far and fast this organisation has come in the last 12 months.

Matthew Kershaw

“Our inspection found that this trust was tackling some difficult issues with energy and focus. The trust was aware of its challenges and had clear and credible plans in place.

“Although there is a great deal of work to be done to make improvements that are needed they have already come a long way.

“Staff are proud of the services they are providing for their patients, and patients are receiving care, treatment and support that achieves good outcomes.”

The ratings were as follows

Overall rating                                    Requires improvement
Are the services safe?                    Requires improvement
Are the services effective?          Good
Are the services caring?               Good
Are the services responsive?      Requires improvement
Are the services well-led?            Requires improvement

The CQC reports contain 90 ratings and of those 64 – or more than 70 per cent – were good, with 25 areas said to require improvement (28 per cent) and 1 inadequate.

Mr Kershaw added: “This report is a fair and balanced assessment of where we are right now and we acknowledge and accept that overall BSUH requires improvement.

“There are though a lot of positives in relation to the ratings themselves – more than two thirds of the individual areas inspected were rated as good – and the open and honest way that we approached the whole inspection and are dealing with things today.

“I also think our staff should be really proud of the fact that the CQC rated us good overall for providing services which were caring and effective and gave special mention to a number of outstanding areas including those for patients with dementia, the critical care teams at both the County Hospital and the Princess Royal and our children’s services.

“I am also very pleased that the inspection team described us as exceptionally open which they said was reflective of the culture across the whole trust and stand out compared to many other trusts they had inspected.

“They also said they had not uncovered anything that wasn’t already being worked on and they had confidence in the approach we are taking which they believe will deliver the necessary improvements.”