The Care Quality Commission (CQC) has today published the findings of its inspection of maternity services and the urgent and emergency care departments in February.
The inspection came about after “information of concern” was received about risks within the urgent and emergency care department.
Maternity services were inspected to follow up on the progress of improvements CQC told them to make at previous inspections.
The Royal Sussex County Hospital (Image: Sussex News and Pictures)
As a result, the maternity services at the trust has improved since the last CQC inspection, but improvements are still needed to ensure they fully meet the needs of women and babies.
The CQC upgraded the maternity service rating from ‘inadequate’ to ‘requires improvement’.
Urgent and emergency care services were also inspected and remain rated as ‘requires improvement’.
Both services are run by University Hospitals Sussex NHS Foundation Trust.
As a result of this inspection, the overall rating for the hospital was re-rated as ‘requires improvement’.
In the urgent and emergency care department, two breaches of regulations were found.
These were regarding safe care and treatment, and privacy and dignity.
This led to a letter of intent being sent to the trust by the CQC, which warns enforcement action will be taken if improvements are not made.
While the maternity service showed improvement, five breaches of regulation were found.
These included delays in induction of labour and caesarean sections, safeguarding, medicines management, issues with the premises at Sussex House, and how well the department was being managed.
Amanda Williams, CQC deputy director of hospitals, secondary, and specialist care in Sussex, said: “During our inspection of Royal Sussex County Hospital, we found several improvements in maternity services.
“Women and people using the service told us staff treated them with compassion and kindness, and we observed strong teamwork between doctors, midwives, and other healthcare professionals.
“However, we also found new concerns around the effectiveness of the service.
“The design and environment of the maternity unit didn’t fully meet the needs of women, people using the service and their babies.
“There was only one dedicated obstetric theatre which impacted the flow of the department.”
Ms Williams noted the successful trial of a second theatre in July 2024, which ended in August 2024 without a permanent solution being implemented.
She also expressed concern about the urgent and emergency department.
She said: “We found several concerns in the urgent and emergency department.
“Some people were being cared for in non-clinical areas, including corridors, which didn’t protect their privacy and dignity.
“We were particularly worried about temporary escalation areas that failed to support effective care, especially for people whose health was deteriorating.
“Some people told us they felt frustrated and weren’t always kept informed about their care.
“The department was severely affected by poor flow across the hospital, leading to delayed ambulance handovers and excessively long waits for admission.
“On the day of our visit, 11 people had been in the emergency department for more than 24 hours waiting for a bed.”
Findings in the maternity service showed the design and environment of the department did not always meet the needs of women and babies.
Baby abduction drills were completed, but not all staff were aware of the policy or procedure.
The department did not routinely undertake audits and had no audit schedule, with sepsis cases going unaudited.
Data from October 2024 showed 69 scheduled caesarean sections were delayed, with 20 of those having a delay of one to three days.
The urgent and emergency services inspection found care being delivered in temporary escalation areas that did not support effective treatment, and the computer system was described as unfit for purpose by staff, who primarily relied on paper records.
Dr Andy Heeps, chief executive officer at University Hospitals Sussex NHS Foundation Trust, said: “I welcome the Care Quality Commission’s recognition of the progress made in our Brighton maternity services.
“I am pleased that inspectors highlighted the compassion and kindness shown by our staff, and the strong teamwork between doctors, midwives and other healthcare professionals.
“Since the inspection in February, we have acted swiftly to use the CQC findings to make more improvements. We introduced extra theatre capacity for election caesarean sections to improve access and reduce delays, and we strengthened leadership with key senior appointments to ensure services are well managed and responsive.
“While the service has moved up a level overall to ‘requires improvement’, with upgrades in the ‘safe’ and ‘well-led’ ratings, we totally accept that we need to go further. We are continually talking with families and staff to understand what more we can do to provide the safest, most compassionate care for mothers, babies, and families across Sussex.”
He also addressed issues within the emergency department.
He said: “The challenges highlighted in the Care Quality Commission’s report on our emergency department are well known, and since the inspection in February we have taken significant steps to address them.
“These include opening a new Acute Medical Unit to help ease pressures, moving patients to other wards at an earlier stage where possible, and working closely with partners to introduce new ways of assessing and caring for people outside hospital – helping to reduce the need for vulnerable individuals to attend A&E in the first place.
“We’ve made progress, but we are under no illusions about the very real pressures facing the local health system. At times, these pressures can be difficult for both patients and staff, particularly in emergency care. Longer-term developments, including the £62 million Acute Floor Reconfiguration project, will further strengthen our ability to deliver safe, timely, and compassionate emergency care for our community.”
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