Health Overview & Scrutiny Committee
Agenda Item 17
Date of meeting: 19 October 2022
Report of: Executive Director, Governance, People & Resources
Contact Officer: Name: Giles Rossington
Tel: 01273 295514
Email: giles.rossington@brighton-hove.gov.uk
1.1 This report presents information (including material submitted by University Hospitals Sussex NHS Foundation Trust: UHSussex) on the recent Care Quality Commission (CQC) inspection of Urgent & Emergency services at the Royal Sussex County Hospital (RSCH), and on UHSussex actions in response to the inspection report requirements and recommendations.
2.1 That Committee notes the contents of this report on the CQC inspection of Urgent & Emergency services at the Royal Sussex County Hospital.
3.1 The Care Quality Commission (CQC) is the national independent regulator and inspector of NHS services. In April 2022, the CQC undertook an inspection of Urgent & Emergency services at the Royal Sussex County Hospital, Brighton (RSCH). The CQ published an inspection report in July 2022. The inspection report published by the CQC includes information on both the inspection of RSCH Urgent & Emergency services and the reinspection of RSCH surgery and maternity services (the inspection report as included as an appendix to the HOSC item on the maternity and surgery reinspection rather than being included as an appendix to both reports).
3.2 The CQC identified a number of problems in urgent & emergency services, including:
· Not all staff completing mandatory training/appraisal
· Patients being regularly accommodated in non-clinical areas unsuitable for clinical care, particularly in terms of providing an appropriate environment for people with mental health problems, and an environment that could be effectively cleansed to minimise infection risk.
· The Needs of people with mental health problems were not fully met, with vulnerable people accommodated for lengthy periods of time in an environment that did not fully meet their needs, and supported by staff without a specialist understand of mental health.
· Delays in access, with poor patient-flow through the hospital causing ambulance handover delays. The Trust regularly exceeded the four and 12 hour emergency care waiting targets.
3.3 Despite these problems, the CQC identified good practice across urgent & emergency services. This included:
· Good risk-assessment and medicines-management and safety incidents managed well despite the pressures the department was under.
· Emergency care was safe, with patients given food and drink and pain medication where appropriate. Staff worked together well in difficult circumstances.
· 24/7 specialist support was on hand including specialist mental health support.
· Staff consistently treated patients with compassion and kindness.
· Staff felt valued, supported and listened to by their immediate leaders.
· The Trust has good relations with external NHS partners, including the local ambulance and mental health trusts.
3.4 As a consequence of its findings, the CQC downgraded RSCH urgent & emergency care from ‘good’ to ‘requires improvement’, although elements of the rating, including the quality of leadership remain as ‘good’. The CQC also required some improvements to be implemented urgently. These include:
· Improve the emergency department environment to ensure that all patients have their privacy and dignity respected.
· Ensure that all areas of the emergency department can be thoroughly cleaned.
· Ensure that all staff complete the appropriate life-saving and safeguarding training.
· Ensure that all patients are cared for within designated patient areas.
· Ensure that all patients with mental health problems are cared for by staff with relevant skills and experience.
3.5 Information on the Trust’s response to the above requirements, and its general plans for improving urgent and emergency care are included in Appendix 1 to this report.
4.1 Not relevant to this report for noting.
5.1 Not relevant to this report for noting.
6.1 Members are asked to note information concerning the recent CQC inspection of urgent & emergency services at RSCH and the Trust’s plans to improve services in response to the CQC’s findings.
7.1 None identified for this report to note.
8.1 No legal implications identified in this report.
Name of lawyer consulted: Elizabeth Culbert Date consulted 01.10.22
9.1 None directly for this report to note. Members may be interested in exploring how the Trust ensures that urgent and emergency services can be accessed by people from protected groups, perhaps particularly people with mental health problems.
10.1 No direct implications identified.
Supporting Documentation
Please note that the appendix to item 16 (CQC Inspection of maternity and surgery at RSCH) provides information on both item 16 and item 17: CQC inspection of urgent & emergency services at RSCH.