Updated 23 December 2022
Mid and South Essex NHS Foundation Trust was formed on 1 April 2020 following the acquisition of Mid Essex Hospitals Services NHS Trust and Basildon and Thurrock University Hospital Trust by Southend University Hospital NHS Foundation Trust.
It is one of the largest hospital trusts in England, serving a population of over 1.2 million people in Central and South Essex.
The combined organisation provides acute and some community services across three main hospitals:
- Southend University Hospital
- Basildon University Hospital
- Broomfield Hospital
The trust also runs some community services and a number of smaller satellite units, enabling people to be treated as close to home as possible. The trust has around 1,800 in-patient beds over the 3 main sites and other community sites. The trust employs over 15,000 members of staff.
At the time of our inspection, and since the acquisition, the trust had not yet been fully inspected. This means that Basildon University Hospital and Broomfield Hospital remain unrated. Southend University Hospital retains its rating of requires improvement.
We carried an unannounced focussed inspection of the following acute services provided by the trust:
- Diagnostic Imaging at Southend university Hospital because we received information giving us concerns about the safety and quality of the service.
- Maternity services at Basildon University Hospital, Broomfield Hospital and Southend University Hospital because we received information giving us concerns about the safety and quality of the service.
We also inspected the well-led key question for the trust overall.
We did not inspect several services previously rated requires improvement because this inspection was focused only on services where we had concerns. We did not inspect any of the other services at the trust as we did not have any information of concern. Our current methodology requires us to apply a risk-based approach to some services. We did not inspect all the services at the Basildon or Broomfield locations even though they have not previously been rated because we did not have any information of concern. We are monitoring the progress of improvements to services and will re-inspect them as appropriate.
At our previous inspection, we issued an urgent notice of decision, under Section 31 of the Health and Social Care Act 2008, to impose conditions on the trust’s registration as a service provider in respect of the regulated activity: maternity and
midwifery services. The conditions set out specific actions to enable the improvement of safety within the service. Following this inspection, the Conditions remain in place.
Our rating of this trust remained the same. We rated them as requires improvement because:
- We rated safe, responsive and well led as requires improvement.
- Not all staff had completed their mandatory training.
- The services did not have enough maternity staff with the right qualifications, skills, training and experience to keep women safe from avoidable harm and to provide the right care and treatment.
- The trust did not always share learning from incidents and take action to ensure mitigating actions were embedded as appropriate across the trust.
- The trust did not always ensure that duty of candour was discharged as soon as reasonably practicable after becoming aware of a notifiable safety incident had occurred in line with the duty of candour regulation.
- Nurses and midwives did not always receive an appraisal in line with the trust's target.
- Women were not always triaged in line with target times.
- People could not always access the service when they needed it and receive the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge women were not always in line with national standards.
However:
- Staff provided care and treatment based on national guidance and evidence based practice.
- Doctors, nurses and other healthcare professionals worked together as a team to benefit women. They supported each other to provide good care.
- It was easy for people to give feedback and raise concerns about care received. The service treated complaints seriously.
- Leaders operated effective governance processes throughout the trust and with partner organisations.
How we carried out the inspection
We carried out the core service inspections from 16 August to 21 September 2022 and the well-led inspection on 11 and 12 October 2022. We visited areas relevant to each of the core services inspected and spoke with several patients, patient representatives and staff.
We spoke with 104 members of staff at all levels of the organisation including healthcare assistants, nurses, midwives, junior doctors, radiographers, radiologists, pharmacy staff, consultants and administrative staff.
We also spoke with 12 patients and relatives. We observed care and reviewed 29 sets of care records. We also looked at a wide range of documents including policies, standard operating procedures, meeting minutes, action plans, risk assessments, training records and audit results.
You can find further information about how we carry out our inspections on our website: www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection