“We understand the challenges, we have made significant progress already, and we know there’s much more to do.”
That’s the message from leaders at University Hospital Sussex NHS Foundation Trust following the publication of the latest report from the Care Quality Commission (CQC) into how services are provided and the organisation is led.
The CQC report relates to seven inspections at the Trust over an 18-month period, the most recent of which was just over seven months ago, and looked at the “Well Led” domain. The Trust’s overall rating has been changed from Outstanding to Requires Improvement, while the ‘Well Led’ domain was reduced to Inadequate.
UHSussex chief executive Dr George Findlay recognised that, like all NHS organisations, the Trust needs to improve as it faces challenges around staffing, fast-growing need for hospital services and recovery from the Covid-19 pandemic.
But he also highlighted the significant positive changes that have taken place both before and since the latest CQC inspection in October 2022, including huge investment in better facilities, a new leadership structure, recruitment at all levels and a big effort to encourage a more open culture.
Dr Findlay said: “When I took up this role just under a year ago, I commissioned an external review to give me a clear picture of where we stood as a newly formed Trust – our strengths and our weaknesses. This review, and our improvement plans were shared with the CQC at the time of our Well Led inspection.
“Everything the CQC is saying now chimes with what we already knew, and had committed to addressing right from the start.
“I’m extremely proud of the huge strides that colleagues have made, but we all recognise how much work still lies ahead. The seven months since this inspection have seen rapid progress – now we need to push on again.”
Improvements made during Dr Findlay’s first year as chief executive include:
- A new leadership development programme to support leaders across the Trust
- A new clinical model to give strong leadership to clinical divisions and individual hospital sites
- A Trust-wide focus on making it easier for people to speak up and raise concerns, including stronger support for the Freedom to Speak Up service. Results from the anonymous monthly ‘Pulse’ staff survey show more people now feel confident that the Trust would act upon concerns that were raised – up from 49% in September 2022 to 58% in March 2023, closing in on the very best-performing Trusts nationally.
- £120m invested across all hospital sites (above and beyond the £500m Louisa Martindale Building and planned £48m redevelopment of A&E in Brighton).
- Weekly, structured sessions with frontline staff involving the whole executive team, and one or more executive team member spending time with frontline teams, every day.
- Strong progress in patient care – including:
- Significant reduction in the number of people facing the longest waits for treatment – now only just over 250 people
- Ambulance delays of an hour or more down to 3.2%, from 9% at the end of 2022
- Waits of more than 6 weeks for diagnostics down by almost a third since late 2022
- Strengthening performance for cancer waiting times, both for diagnosis, and treatment.
The CQC team visiting in 2022 also concluded:
- New strategies would “improve quality for patients and staff”.
- “Majority of leaders had the experience, capacity and capability to lead effectively”.
- “Most patients praised the care, treatment and support they received”.
- “The executive team had an appropriate range of skills, knowledge and experience.”
- “The new operating model appeared to provide clear structures and evidenced multi-disciplinary leadership both across hospital sites and divisions.”
Dr Findlay said: “Right from my first day, the focus has been on facing up to our problems and giving our amazing staff the tools and support they need to do their jobs. None of the issues raised in this report are new to us, and that is why we were already addressing them.
“Much has changed since the CQC team was here, and that progress makes me confident for the future – delivering NHS care at the moment is really tough, making improvements is tough, but we have the plans and the people in place to do that.
Adam Doyle, Chief Executive Officer of NHS Sussex, said: “We acknowledge the findings of the report and are working closely with the Trust, the Care Quality Commission and NHS England to ensure the necessary improvements are made.
“We recognise the hard work and progress that has already been made to address many of the areas outlined in the report and will continue to support the Trust to deliver the improvement plans that are in place for some of the other long-standing challenges that will take time to address, both across the organisation and in collaboration with system partners.”