Southend University Hospital

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities. This assessment did not cover all parts of our Assessment Framework; therefore, we have only given scores for those areas which we have assessed. We will carry out future assessments to cover other parts of the Framework and will update our website with our findings. At our last inspection we rated this key question requires improvement. At this inspection the rating has remained requires improvement. We found that the service did not always have effective governance arrangements in place. Staff did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. The service was in breach of legal regulations in relation to governance.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The service did not always have effective governance arrangements in place. Staff did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The service did not always have effective systems to manage current and future performance and risks to the quality of the service. Leaders acknowledged there had been an increase in demand on the service, which had impacted on safe staffing levels. Leaders reviewed and adjusted staffing levels on a daily basis but recognised that this was not a long-term solution. Leaders had drawn up a workforce plan but the trust’s financial position meant that there had been a freeze on recruitment. Leaders had escalated concerns regarding staffing shortages and skill mix in the PED to the senior leadership team but this had not yet been addressed at the time of our assessment.

Some staff felt changes were being made to service provision without adequate consultation with staff.

Staff said risk was not always managed well. Staff said that some senior leaders were not always visible to offer support at times of high demand and acuity. Local leaders were effectively working 24 hours a day, as nurses escalated concerns to them even when they were not on shift. The service used a nationally recognised capacity and risk tool, but staff told us capacity escalations at times of high demand were not always acted on effectively by leaders. This was supported through a review of capacity trackers during our assessment.

The service did not always have clear and effective governance arrangements. For example, divisional triumvirate meetings were not minuted and no action log was kept. This meant
that we could not gain assurance about the content of meetings, the attendance at meetings or the frequency of meetings. The lack of meeting minutes also meant that the service did not have an audit trail of discussions held and actions identified to address any areas of concern.

The service did not have a systematic programme of clinical and internal audit. There was limited evidence of audits which monitored compliance with national guidance and which monitored patient outcomes. Audits were not always being completed at the frequency set out in the provider policy. It was not always clear what actions had been taken in response to areas of concern identified during the completion of audits.

The service did not always have robust arrangements to ensure that information was collected, analysed and managed appropriately. A significant amount of information requested as part of our assessment was not provided or available.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.