CQC orders 'rapid improvements' at Conquest Hospital in St Leonards after emergency care downgrades

The Care Quality Commission (CQC) said it has downgraded the services from 'good' to 'requires improvement'.

It rated urgent and emergency care at Eastbourne District General Hospital (DGH) as 'requires improvement'.

Both hospitals are run by East Sussex Healthcare NHS Trust.

A CQC spokesperson said: “At Conquest Hospital, inspectors found leaders hadn’t ensured the department had dedicated pharmacy support, so people didn’t always receive their regular medicines on time. One person was in the department for nearly 24 hours without critical blood clot and blood pressure medications.

“The trust didn’t ensure the service still had access to 24-hour cardiology cover, which meant someone waited overnight before receiving a specialist cardiology review. Staff said they should have been transferred to specialist cardiology care sooner.

“Leaders weren't ensuring there was sufficient paediatric nursing staff. There should have been a minimum of two paediatric registered nurses per shift, but the service regularly had just one and on 15 occasions in one month, there was no paediatric registered nurse at all.

“Leaders had failed to effectively tackle risks that had been on their risk register for more than five years. These included poor sepsis management and overcrowding. As a result, people remained at risk of these known concerns.”

However, the CQC added that leaders had 'created a supportive and caring team culture, where staff felt comfortable raising concerns and reporting incidents'.

The spokesperson added: “Leaders had a clear vision for urgent and emergency care, and both staff and leaders felt positively about improvement plans. The service was trialling an AI enabled patient tracking system and this had reduced the time people spent in the emergency department by 21 per cent.”

The CQC has told the trust to submit an action plan for the Conquest and DGH, showing what action it is taking to make immediate improvements.

The CQC said the overall rating for the Conquest Hospital has changed from 'outstanding' to 'good', while the overall rating for Eastbourne DGH has changed from 'good' to 'requires improvement'.

Amanda Williams, CQC deputy director of hospitals, secondary and specialist care in the South East, said: “When we visited the urgent and emergency care services at Conquest Hospital and Eastbourne District General Hospital, we found departments that were operating under sustained pressure and where staff were struggling to provide safe and effective care for people.

“We saw staff treating people with kindness and compassion, and this was reflected in positive feedback from people and their families. However, both emergency departments experienced significant overcrowding, primarily driven by issues with flow across the hospitals which leaders must look to address.

“For people needing urgent care, this too often meant long waits for treatment or transfer to a ward, and a risk of deterioration or prolonged pain. For example, one person with a potentially life-threatening condition spent more than six hours waiting for a scan because of delays in accessing diagnostics.

“Like many emergency departments, staff had to care for people in temporary escalation spaces (known as corridor care) to cope with demand and this wasn’t always safe. We saw people didn’t always have call bells to alert staff if they needed help and staff couldn’t always protect people’s dignity and privacy. One person described their care as undignified.

“It was clear leaders were capable and committed but they weren’t identifying or managing risks effectively and hadn’t taken sufficient action to address persistent issues such as delays in accessing specialist beds.

“We’ve told leaders where we expect to see rapid improvements and requested action plans for both services.”

The CQC inspections were carried out in February, with the latest reports published this week.

Jayne Black, chief executive of East Sussex Healthcare NHS Trust, said: “We accept the findings of the CQC and recognise that there were areas where the care provided in our emergency departments was not consistently at the standard our patients should expect.

“These inspections took place in January and February and we have made a number of changes since then. These include strengthening rapid assessment at the front door, increasing senior clinical oversight of patients waiting in our departments, improving staffing and escalation arrangements, and strengthening the day-to-day management and oversight of our emergency departments. We are also continuing work to improve patient flow and reduce overcrowding and long waits.

“There is more to do, particularly around flow through our hospitals, and we are not complacent about that. Our focus is on making sure the improvements are sustained and translate into safer, more timely care for patients.

“We are grateful to our colleagues who continue to work extremely hard under considerable pressure, and welcome the CQC’s recognition of the kindness, compassion and professionalism shown by our teams.”