Health Overview & Scrutiny Committee
Agenda Item [Insert]
Date of meeting: 19 October 2022
Report of: Executive Director, Governance, People & Finance
Contact Officer: Name: Giles Rossington
Tel: 01273 295514
Email: giles.rossington@brighton-hove.gov.uk
1.1 This report provides an update on the improvements made to maternity and surgical services at the Royal Sussex County Hospital (RSCH) following a Care Quality Commission inspection report published in December 2021, and a subsequent reinspection report published July 2022.
1.2 Information provided by University Hospital Sussex NHS Foundation Trust (UHSussex), is included as Appendix 1 to this report.
2.1 That Committee is asked to note the contents of this report on improvement planning at the Royal Sussex County Hospital with regard to maternity and surgery services.
3.1 The Care Quality Commission (CQC) is the national NHS regulator/inspector. The CQC conducted an unannounced inspection of maternity and surgery services at UHSussex hospitals in September/October 2021, publishing its inspection report in December 2021. The CQC downgraded its ratings of services at all UHSussex hospitals, but of particular concern was the RSCH, where surgery and maternity services were downgraded from ‘good’ to ‘inadequate’.
3.2 The Trust undertook a range of urgent actions in response to the CQC’s findings. These were outlined to the HOSC at its 26 January 2022 meeting. The Trust also put together a longer term action plan, with input and monitoring from health & care system partners.
3.3 RSCH surgery and maternity services were reinspected by the CQC in April 2022. The CQC did not update its ratings of these services, but did publish a detailed report on its findings: https://api.cqc.org.uk/public/v1/reports/c55b73a3-3d17-4e31-833e-59556e80cc95?20220729070335
3.3.1 Maternity. The CQC found significant improvements across maternity services, with more comprehensive staff training, improvements in recruitment, better record-keeping, enhanced incident-reporting, more responsive leadership, and a happier workforce. The CQC did require the Trust to make some further improvements to the checking of clinical equipment, to elements of patient records, and to maintaining appropriate temperatures in environments where medicines are stored.
3.3.2 Surgery. The CQC found some improvements in surgery: e.g. in terms of better infection prevention processes; improved training completion; better reporting of safety incidents. However, the CQC also found that problems remained in a number of areas, including the cancellation of planned surgery, recruitment of suitably skilled nursing and support staff (e.g. theatre nurses), leadership, and staff morale. The CQC noted that their re-inspection followed a challenging winter, due to a combination of Covid infections and the usual seasonal pressures. The Trust was confident that some of its performance was a consequence of these pressures, and that things would improve as pressures eased. The CQC required urgent improvement in a number of areas: better monitoring of the risk to patients when surgery is cancelled; ensure the timely completion of mandatory training; ensure that appropriately qualified staff are employed in theatre and recovery; ensure that patients requiring surgery do not experience harmful delays; improve the patient-flow through the hospital; ensure that the hospital has sufficient high dependency/intensive care capacity; ensure that there are enough staff to keep patients safe.
3.4 Details of the actions being taken by UHSussex in response to the CQC’s reinspection report findings are included in Appendix 1 to this report.
3.5 The April 2022 CQC visit also included inspection of A&E services. The CQC’s findings are detailed in a separate report to the HOSC.
4.1 Not applicable to this report for noting.
5.1 Not applicable to this report for noting.
6.1 Members are asked to note progress in UHSussex improvements in surgery and maternity services at RSCH, and the findings of the April 2022 CQC reinspection of these services.
7.1 None to this report to note.
Name of finance officer consulted: Date consulted (dd/mm/yy):
8.1 No legal implications identified to this report.
Name of lawyer consulted: Date consulted (dd/mm/yy):
9.1 Not directly for this report to note.
10.1 Not directly for this report to note.
Supporting Documentation
1. Information provided by University Hospitals Sussex.
2. CQC Inspection Report of RSCH Surgery and Maternity April 2022