- NHS hospital
Royal Sussex County Hospital
Assessment report published 17 December 2025
Contents
Ratings - Urgent and emergency services
Our view of the service
Date of assessment 26th and 27th of February 2025
We carried out an unannounced assessment of the Urgent and Emergency Services at the Royal Sussex County Hospital, Brighton. This assessment was in response to information of concern we received associated with risk within the service.
We last assessed Urgent and Emergency Services in 2022 and rated the service as requires improvement.
The service was previously in breach of regulation 12 Safe Care and Treatment and regulation 10 Dignity and respect. Improvements were not found at this assessment, and the service remained in breach of regulations. The rating for Urgent and Emergency Services has been combined with ratings of the other services from the last assessments. The rating of Royal Sussex County Hospital remains requires improvement overall.
We assessed this service using our single assessment framework and looked at all the key questions and 24 quality statements. We visited the major assessment and treatment area, minor assessment and treatment area, mental health assessment area, ambulance arrival area, resuscitation area, patient assessment and triage, ambulatory emergency department and the urgent treatment centre (UTC). We spoke with 40 patients and relatives/carers. We reviewed 20 patient records. We spoke with more than 60 staff which included: leaders of all levels, nurses, doctors, allied health professionals, administrators, paramedics, estates staff, site coordinators, practice educators, health care assistants, GP’s, Emergency Nurse Practitioners, flow coordinators and pharmacy technicians.
We found 2 breaches in regulation in relation to safe care and treatment and privacy and dignity. People waited within the department for long periods of time, the department was overcrowded, and staff could not always track where each patient was. Staff could not always get emergency equipment to patients. Fire exits were blocked; no nominated fire officer and staff did not understand of the evacuation process. It was not possible to clean the floor of the temporary escalation area as there were too many patient trolleys.
People experienced long delays before being admitted to a ward. Seriously unwell patients could not be monitored safely in high dependency areas of the department due to overcrowding. People’s privacy and dignity could not be maintained, and staff could not regularly check the patients’ comfort, skin integrity or ensure patients had enough to eat and drink.
The trust operated local clinical governance processes under the urgent care and medicine triumvirate. A clinical policy group managed monthly meeting agendas. The Acute Floor Directorate oversaw clinical governance and submitted reports to the Divisional Governance Group. In turn, the Divisional Governance Group reported to the Quality Governance Steering Group (QGSG), which the Chief Nurse and Chief Medical Officer jointly chaired.
Following the assessment, we issued a letter of intent about possible urgent enforcement action under section 31 of the Health and Social Care Act 2008 and asked the provider for an action plan in response to the serious concerns found at this assessment. The CQC met weekly with the senior leadership team to monitor compliance with the action plan until June 2025.
People's experience of this service
We spoke with over 40 patients. Patients and any family or carers with them were not positive about their experience. Patients told us their care did not prioritise dignity and respect. This was due to the environment they were cared for in and the proximity to other patients in the department. Patients were unhappy with the long waits in the department and the standard of care they received. There were occasions where their medical and nursing needs were not met. For example, pain relief and personal care. This concerned their family members. However, patients and family members were happy with the staff who provided care and understood they were doing their best in difficult circumstances. They told us staff communicated and listened to them well when they attended to them.