CQC statement after Sussex NHS Foundation Trust report

The Care Quality Commission (CQC) has downgraded the overall rating of University Hospitals Sussex NHS Foundation Trust after an inspection between October and December showed a decline in the care being povided to people across several key areas.

At the inspection last autumn, the CQC looked at neurosurgery and children and young people’s urgent and emergency care as well as management and leadership of the trust. 

This followed other inspections at the trust over an 18-month period, which highlighted failings in several departments and was in part prompted by whistleblowing concerns from staff.

As well as the decline in its overall rating, how well-led the trust is has declined from outstanding to inadequate. How responsive and safe the trust is has also dropped from outstanding to requires improvement. The criteria of effective and caring remain outstanding.

Deanna Westwood, CQC’s director of operations in the South, said staff were “let down” by leadership and many felt “fearful” to raise concerns to management.

“We carried out this inspection of University Hospitals Sussex NHS Foundation Trust in response to concerns raised with us around culture and leadership,” she said.

“At the time of our inspection we found staff on the front line doing their best to provide safe and effective care and treatment despite significant pressures and a challenging working environment.

“However, staff and people using services were being let down by senior leaders, especially the board, who often appeared out of touch with what was happening on the wards and clinical areas and it was affecting people’s care and treatment.

“Staff told us they felt unable to raise concerns without fear of reprisal so I want to praise those who were brave enough to come forward anyway, despite those fears. Speaking up in these circumstances isn’t easy but is incredibly important to give us an accurate picture of these services. 

“We found a culture developing where safety concerns were normalised and when a member of staff raised issues about this, leaders focused on an individual’s poor behaviours or performance issues rather than any systemic failings. This had an impact on the organisation’s ability to address and learn from safety concerns.

“There was a clear disconnect between leaders and staff, leading to this poor and unsupportive culture. The board need to take ownership of this and work with staff to ensure their concerns outlined in our report are addressed.

“It’s also clear the trust needs help to ensure significant improvements in leadership are put in place to give them the support they need. The trust has been receiving support and oversight from key stakeholders after we shared our concerns with them.

"However, I am recommending to NHS England that the trust should be placed in segment four of the system oversight framework and receive additional support via their recovery support programme. This is the highest level of support that‘s offered and should give the trust the extra help needed to make the required improvements.

“At the time of this inspection the new chief executive had been in post for four months. The board know where they need to improve and we will continue to monitor services closely, including through future inspections to ensure this is rapid and widespread. If this does not happen, we will not hesitate to take further action to keep people safe.”