East Sussex Healthcare Trust has been rated as “inadequate” by the Care Quality Commission, with much of the regulators’ criticism focused on managers while nursing staff were seen as caring.
Inspectors were concerned by the disconnect they found between senior management and other staff, and said they saw a higher number of staff than expected who wished to remain anonymous.
The CQC’s report stated: “We saw a culture where staff were afraid to speak out or to share their concerns openly.”
The inspectors found that waiting times in outpatient services were “excessive” and that some specialisms had long waiting lists, with rheumatology patients having sometimes waited 48-49 weeks for treatment.
In addition, there were low staffing levels in surgery, maternity and pharmacy. The CQC team also found that at the time of inspection the trust had higher than expected mortality levels.
However, the trust was rated “good” for how caring its services were. “Outstanding” practice was also found in clinical leadership and among consultants in critical care and nurse-led discharge.
“I am still concerned about cultural and leadership issues at the trust”
Meanwhile, the inspectors found bad feeling among local stakeholders over the recent reconfiguration of services, which had seen consultant-led maternity and paediatrics centralised at the trust’s Conquest Hospital in Hastings.
The report said: “The trust had just undertaken a major and contentious reconfiguration of some of its clinical services. We did not see a clear vision for the trust going forward from this.
“Following the reconfiguration, there was a loss of trust from some of the stakeholders in the trust management,” it said.
The CQC report was based on findings from an inspection by the CQC in September. However, a further inspection took place last week – just two days before the report on the initial inspection was published.
A CQC spokesman confirmed that a decision on whether to place the trust in special measures would not be made until Sir Mike had considered the new findings. He said early indications showed that improvements had been made, but concerns still remained.
CQC chief inspector of hospitals Sir Mike Richards said: “When we inspected East Sussex Healthcare in September, we were extremely concerned at the disconnect we identified between the senior team and the staff working on the frontline.
“Our recent inspection indicates there have been improvements in important areas for patients, but I am still concerned about cultural and leadership issues at the trust. I will not be making a judgment about special measures until we have fully assessed the results of our most recent inspection.”
“It isn’t an overnight job to change the culture of a large complex organisation such as ours”
Trust chief executive Darren Grayson said: “We are incredibly disappointed to receive the ‘inadequate’ rating from the CQC, although we welcome the feedback from their inspection this week that improvements have already been made since they inspected last September.
“It is testament to our excellent frontline and support staff that they are recognised as delivering compassionate care to the thousands of patients who need our services every day,” he said.
He added: “I have always been honest about the fact that it isn’t an overnight job to change the culture of a large complex organisation such as ours and that there is always more that we can and want to do.”
A joint statement from the three clinical commissioning groups in the area said they took the CQC’s findings “very seriously”.
But they added: “We are pleased to note the areas in which the trust is rated ‘good’, particularly in delivering caring services across the board. This reflects excellent nursing leadership and the professionalism and skill of many dedicated staff.”