- NHS hospital
Basildon University Hospital
Report from 25 April 2025 assessment
Contents
Ratings - Medical care (Including older people's care)
Our view of the service
Medical services
Basildon University Hospital is operated by Mid and South Essex NHS Foundation Trust. The hospital provides elective and emergency services to a local population of 450,000 living in and around the southwest Essex area.
Medical wards provided by Basildon University Hospital include general medicine, gastroenterology, endocrinology and diabetes, palliative medicine, cardiology, acute medicine, respiratory, renal, geriatric medicine, stroke with in-reach services provided by dermatology, rheumatology and neurology.
Between January 2022 and December 2022 medical care had 30,213 admissions. The specialties with the highest number of admissions during the same period were general medicine (10,700), cardiology (6,376) and gastroenterology (5,611).
Date of Assessment:
We carried out this assessment on 17 and 18 December 2024 as part of our system pathway pressures programme. We inspected 23 quality statements across the key questions Safe, Effective, Caring, Responsive and Well-led and have combined the score for each of these areas to give the overall rating.
During the inspection, we visited a number of wards and assessment units. We reviewed the environment and staffing levels and looked at care records and prescription records. We spoke with patients and family members, staff of different grades, including nurses, doctors, ward managers, therapists and the senior managers who were responsible for medical services. We reviewed performance information about the trust. We observed how care and treatment was provided.
There was a positive safety culture where events were investigated, and learning was embedded to promote good practice. Infection prevention and control processes enabled patients to be safer from the risks of infection. However, continued improvements to the general environment were required.
Safe systems and pathways were not always maintained and responding to risk still required some improvement.
Patients with mental health care needs did not always have sufficient numbers of staff available to meet their needs and keep them safe.
Staff were not always fully trained or had the right skills for their role, and they did not always provide safe care and treatment to patients.
Medicine optimisation remained unsafe at times.
Staff had made improvements to ensure patients were able to make informed decisions about their care and treatment.
Staff did not consistently complete comprehensive patient assessments to inform their care and treatment. Staff delivered evidence-based care and treatment to ensure patients had good experiences and outcomes.
Staff worked with other professionals when assessing patients. However, information sharing was sometimes limited, which impacted the effectiveness of collaborative working and continuity of patient care.
Staff were mostly kind, caring and compassionate with patients and their visitors.
The service supplied appropriate, accurate, and up-to-date information in formats that were tailored to individual needs.
Staff worked hard to provide equity in access. However, significant working pressures sometimes impacted patients being able to access care and treatment when they needed it.
The service had a shared vision and culture based on the strategic objectives and values of the organisation. Staff feedback about this was mixed and we saw organisational challenges impacted on staff being in a position to maintain this.
The department and staff were led by strong leaders who embodied the cultures and values of their workforce. However, some staff told us, leaders could be more visible.
Governance and risk management had improved, though further sustainable improvements were needed.
There was a continued focus on learning, innovation, and improvement with processes to support staff to speak up if they had any concerns.
Staff collaborated and worked in partnership to assist continuity of care and system improvement.
During this inspection, we found the service had continued to make improvements since the inspection in July 2023. We did find breaches of the legal regulations during this inspection, though it was evident that the service was on an improvement trajectory.
We found five breaches of the legal regulations concerning safe care and treatment, premises and equipment, and good governance.
Staff did not consistently assess the risk to the health and safety of service users receiving the care or treatment.
The service did not always ensure that persons providing care or treatment to service users had the competence, skill and experience to do so safely.
Staff did not always maintain the proper and safe use of medicines.
The service did not consistently maintain the environment.
While there had been some improvements in governance system, there were repeated breaches which reflected improvements were not always being sustained. Staff also did not maintain secure and accurate, complete and contemporaneous records in respect of each service user, including a record of the care and treatment provided to the service user and decisions taken in relation to the care and treatment provided.
We have asked the provider for an action plan in response to the concerns found during this assessment
People's experience of this service
Most patients and their families were positive about staff who treating them with warmth, kindness and respect. During our inspection we observed most staff were kind and compassionate, responding to patients’ needs in a timely way, though there were isolated incidents where this did not happen.
Some patients and families reported there had been a lack of communication about their care and treatment and clarity about the discharge process. One patient told us They thought they had been forgotten as they were left waiting for 6-7 hours for an update on what was happening.
We heard of chaotic environments that impacted patients’ health and wellbeing. Some patients had also endured long waits for a bed in the hospital corridors and then experienced multiple wards/unit transitions.
Records showed while patients were seen by the required specialist, there were gaps and omissions in record keeping demonstrating patients had received the care, treatment, and support they needed to keep them safe and well.
We tracked the experiences of five patients on medical wards from admission, the findings of which had been consolidated within the main body of the report.