Latest CQC inspection report for Sussex NHS hospitals

Doctors at the Royal Sussex County Hospital are facing “difficult circumstances” on a daily basis, Care Quality Commission inspectors found.

During their visit to the hospital, dozens of staff reported examples of bullying within the surgery department.

The inspectors' report, released today, criticised a disconnect between hospital staff and the trust’s management, which was having a knock-on effect on the quality of care.

It said the culture in the hospital’s theatres was “still poor”. Staff also reported “high levels of frustration” with their working conditions.

The report said: “Staff in general theatres told us the culture continued to be negative.

“We spoke with 30 members of staff who gave us examples of bullying in the unit with a divided workforce and a perception that some staff were treated differently to others.

“Staff told us they were placed in difficult circumstances daily and they did not feel listened to when they reported these concerns.”

Other concerns raised by the report include:

• Staff not feeling safe to report bullying 
• Senior medical staff feeling “emotionally targeted” with threats of “career consequences” if they did not take on extra work
• Annual leave requests being “frequently” denied by senior leadership.

The report highlighted concerns about a lack of medical staff and the impact on care. 

The inspection, which took place at the beginning of August last year, found just half of the neurosurgery theatres at the NHS hospital were being used due to staff shortages.

Medical staff were told the new Louisa Martindale Building, which opened last year, would provide more space but that “this could not be utilised due to the lack of staff available”.

The Louisa Martindale Building (Image: Sussex News and Pictures)

Improvements were found in surgery wards but the report stressed that more work was still needed.

Concerns were also raised about communication between frontline staff and senior leadership who were described as “not visible and distant from the problems”.

Neil Cox, CQC deputy director of operations in the South, said: “We found a wide disconnect in the relationship between staff and senior leaders and how they were working together. These issues were clearly having a knock-on effect on the quality of care being delivered to people using services.

“We saw some improvements in the culture issues we found in theatres at previous inspections. However, there were still reports of bullying and low staff morale as a result of not feeling listened to, although the trust was taking steps to support staff in speaking up.”

The report found the hospital, which is run by University Hospitals Sussex NHS Foundation Trust, "requires improvement". This was a step up from the previous report which rated it inadequate.

But Worthing Hospital and St Richard’s Hospital in Chichester, which are also run by the trust and were previously "outstanding" were downgraded to “requires improvement”. The Princess Royal Hospital in Haywards Heath still "requires improvement" as it did at the last inspection.

The latest report comes after an investigation by The Argus found people were dying in the corridors of the Royal Sussex emergency department.

Doctors and nurses in the department said the situation was “the worst it has ever been” and said staff in A&E were thinking of leaving.

One woman described seeing a patient she believed was dead being wheeled past trolleys and people waiting to be seen so crammed in they were within touching distance of each other.

Corridor care in the Royal Sussex County Hospital (Image: Submitted)

In one incident in Worthing inspectors found that confidential patient information was “easily accessible”. The report described a “gridlocked” surgery system with patients forced to recover from anaesthetic in operating theatres due to a lack of space.

Findings in Chichester and Haywards Heath included an operating theatre entrance being blocked by equipment stored in a corridor. Emergency surgeries were also “not always received in a timely manner”.

Medical care services in Brighton and Worthing were also inspected by the CQC and downgraded to requires improvement. Brighton was previously good and Worthing was outstanding.

Incidents in medical care services at the Royal Sussex included a patient ringing their call bell 28 times before it was answered.

Boiling water dispensers were found to be available in elderly wards which the CQC said posed a potential scalding and burns risk to dementia patients.

All of the sites were found to be "caring" with each hospital rated “good” or “outstanding” in this category.

The CQC noted instances where staff took home one person’s clothes to wash as they had no family to do it for them. A patient’s relative was also given nail polish so they could paint their loved one’s nails.

Other examples of “exceptionally caring” staff included ensuring patients had their favourite biscuits.

Dr George Findlay, chief executive at University Hospitals Sussex, said: “The CQC inspection team found frontline teams giving good patient care, treating patients with kindness and respect, and working well together.

“Those are fundamental strengths and it is to their enormous credit that they are giving such good care in such difficult circumstances.

“But the CQC also found too many things that we need to do better – from more consistent record-keeping to training, to managing pressures on overstretched staff, improving our culture and making colleagues feel more confident to speak up.

“We accept those challenges and we are working hard to put them right.”