Three hospitals in Essex have been ordered to make urgent improvements in their medical care services, by the health and care regulator. The Care Quality Commission (CQC) served Mid and South Essex NHS Foundation Trust with a warning notice over the quality of care at the Southend University Hospital, Broomfield Hospital, and Basildon University Hospital, following a focused inspection in January and February.
The inspection was prompted following concerns received about the safety and quality of medical care and older people's services in the hospitals.
CQC inspectors found issues with nutrition and hydration, patient dignity and privacy, records and risk assessments, staffing shortages, long waiting times, estates backlogs, and mandatory training in the three hospitals.
Following the inspection, all three hospitals are now rated as 'inadequate' overall for medical care, down from the previous rating of 'requires improvement'. They are also rated 'inadequate' for being safe, effective and well-led.
This inspection of medical care has affected the overall rating of both Basildon Hospital and Broomfield Hospital, which have now dropped from 'requires improvement' to 'inadequate' as have their ratings for safe, effective and well-led. Southend Hospital remains rated as 'requires improvement', while Mid and South Essex NHS Foundation Trust remains rated as 'requires improvement overall'.
The trust has provided CQC with an action plan outlining how it intends to address the areas of concern outlined in the warning notice and said significant improvements have been made since the inspection.
Rapid Improvements Needed
Commenting as the inspection reports were published today, Hazel Roberts, CQC deputy director in the east of England, said: "Following our inspection of medical care at the Mid and South Essex NHS Foundation Trust, we found a leadership team who didn't have complete oversight of the issues they're facing.
"We've highlighted a number of issues where they need to have far better oversight and where we want to see significant improvements. This includes making sure people are able to access the service when they need it, and that there are enough trained staff to care for them safely.
"Leaders need to ensure they are allowing staff the time to complete essential training, including safeguarding and conflict resolution. This helps staff to understand and look out for risks and how to deal with them. Without this training, staff weren't always able to complete and update risk assessments for each person to remove or minimise these risks."
She said it was also disappointing that people's privacy and dignity wasn't always respected. "We found areas in all three hospitals where a ward at full capacity didn't have curtains or screens to provide privacy and dignity to every person occupying a bed."
Ms Roberts acknowledged that the inspection did have some positive findings, with staff mostly treating people kindly and with care. "However, we also saw in some areas, staff didn't always support people to make informed decisions about their care and treatment, especially when the person lacked capacity to make their own decisions or was experiencing a severe mental health crisis.
"We are aware the local integrated care system is supporting the trust, as are NHS England, and they should use this additional expertise and resource to make the rapid improvements that we need to see."
The CQC would re-inspect the hospitals to ensure improvements were being made "and won't hesitate to take further action if needed to protect people", Ms Roberts added.
Work Already Underway to Address Issues Raised
In a statement issued to Medscape News UK, Hannah Coffey, acting chief executive of Mid and South Essex NHS Foundation Trust, said: "This is a hugely disappointing report. Work is already well underway to address the issues raised, and that was recognised by the inspectors. We are an organisation committed to quality improvement, and to providing the best possible care for our patients.
"We are disappointed that, while there are no other services apart from medicine rated as inadequate at any of our hospital sites, the algorithm used by the CQC means that they have now rated Broomfield and Basildon Hospitals as inadequate overall. When we merged to become one organisation, the previous ratings for Basildon and Broomfield were erased, meaning that only a very small number of services on those sites have been inspected. This has had an impact on their overall rating.
"We know that there is more to do to make sure we are getting it right for every patient, every time. But we have dedicated, hard-working staff who are pulling out all the stops to ensure we provide excellent care to those who need it."
Ms Coffey said that in the 5 months since the inspection, significant improvements had been made to inpatient environments and nutrition and hydration, and there has been a significant reduction in staff vacancies and turnover. "We know we have a lot to do to improve the ratings for medical services and are absolutely committed to this work," she said. "We are very clear about what needs to be done and confident we can build on the positive changes already made to get the basics right every time, for every patient."