An unannounced two-day official inspection has started at the Royal Sussex County Hospital, in Brighton, this morning (Wednesday 26 February).
The Care Quality Commission (CQC) is focusing on the accident and emergency (A&E) and maternity departments.
The hospital trust chief executive George Findlay emailed staff earlier today.
The most recent CQC report on the Royal Sussex was published in February last year after an inspection over three days in August 2023.
It found that the staff provided outstanding care but safety and effectiveness required improvement – as did responsiveness and the leadership.
The Royal Sussex is run by University Hospitals Sussex NHS Foundation Trust. At its most recent inspection in October 2022, the trust was found to provide outstanding care, effectiveness and use of resources.
But the report, published in May the following year, said that the safety and responsiveness “requires improvement” and under the heading “well-led”, the trust was graded inadequate.
Maternity services at the Royal Sussex are currently described as inadequate on the CQC website. A report published in December 2021 said that they were inspected two months before but not rated.
The inspection followed “staff whistleblowing, patient complaints and information from other regulatory bodies”, and a programme of improvements was put in place afterwards.
The report said: “The service did not have enough staff to care for patients and keep them safe. Infection prevention and control standards and practices were not consistently applied across some areas.
“Staff did not have training in key skills. Not all staff were up to date with emergency life support training.
“The service did not manage safety incidents well and did not always learn lessons from them. Leaders did not run services well or support staff to develop their skills.”
The CQC website said that urgent and emergency services, including A&E, required improvement. An inspection report published in July 2022 said that the services were inspected in April of that year “following some information of concern”.
The report praised staff as they tried to manage the influx of patients, including those who needed help with their mental health, in corridors and other unsuitable spaces.
The report said: “The use of the environment did not always support keeping people safe. Patients were frequently accommodated in non-clinical areas. The use of the environment did not always enable staff to protect the privacy and dignity of patients.
“The environment of the short stay areas did not support effective care for patients accommodated there which included patients with mental health illnesses.
“The environment posed an infection risk as it could not be cleaned effectively.
“The service was not able to plan and provide care in a way that met the needs of local people and the communities served. The needs of patients in the local community with mental health conditions were not fully met.
“They were accommodated for lengthy periods of time in an environment that did not fully meet their needs and by staff who may not have the skills to care for the patient.”
A long-overdue modernisation of the hospital buildings has been taking place over several years, with a budget of more than half a billion pounds.
A&E was not part of the main modernisation project but several tranches of money have been allocated to try to improve the area where many patients arrive at the Royal Sussex.
One of the problems, identified by the trust as well as the CQC, is the flow of patients through the hospitals.
Delays in discharging patients – known as bed-blockers although they are not at fault – can make it hard for staff in urgent and emergency services to admit patients to a ward in the hospital.
Bed occupancy remains stubbornly high as the hospital treats more patients who are increasingly older and with a more complex mix of medical needs.
The trust, University Hospitals Sussex, runs more than half a dozen hospitals across Sussex including the Royal Alexandra Children’s Hospital and Sussex Eye Hospital, also both in Brighton.
Complaints about deaths and serious harm to patients during or after neurology and general surgery at the Royal Sussex have led to a police investigation known as Operation Bramber.
About 200 cases are understood to be under investigation over a number of years involving at least 40 deaths and possibly as many as 90.
Good to see