Basildon University Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Assessment findings:

We looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. We assessed four quality statements.

At our last inspection we rated this key question requires improvement. At this inspection the rating improved to good.

This meant the effectiveness of people’s care, treatment and support achieved good outcomes.

This service scored 62 (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 Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them.

Assessment findings:

Processes were in place to ensure staff had access to clinical guidance and support. For example, a medical model ensured gastroenterology patients received care in a timely way anywhere in the hospital. Clinical staff used the National Early Warning Score (NEWS) to determine the degree of illness of a patient so they could respond to any deterioration in their condition quickly.

The service had systems to support staff to remain up to date with national legislation and good practice standards. Staff mostly planned and delivered patient’s care and treatment with them, including what was important and what mattered to them. Clinical staff collaborated with multiagency teams to ensure the right people could deliver evidence-based care and treatment.

Medical services participated in national clinical audits. For example, National Heart Failure Audit, the National Audit of Inpatient Falls and the National Audit of Dementia. Action plans where required, were put into place to improve patient outcomes following the outcome of these audits. These action plans were monitored to ensure all actions were completed. Services were also required to identify clinical audit priorities and establish a priority programme that was kept under review

The service monitored compliance against NICE guidance. At the time of the inspection there were none were overdue for review of implementing the guidance.

The service did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

Assessment findings:

Some patients told us they had experienced multiple ward changes and had to repeat their stories more than once.

Staff reported good multidisciplinary relationships. We observed this in practice and patient records demonstrated they had seen relevant specialists when they needed to.

There was therapy input onto wards which we observed to work well. Therapy staff said they were busy but did feel there was adequate staffing levels to work well with ward teams.

Some staff told us transitions of patient care would be more effective with improved verbal and written communication between staff. While reviewing patient records, we found inconsistencies in the accurate and comprehensive completion of these. For example, assessments completed by therapy teams were in-depth and person centred. However, some clinical records we reviewed showed gaps in assessments and associated action plans. This meant staff, teams and services were not always working well together to share information and there was a risk that patients may not always receive the care, treatment and support they needed.

We found the discharge process was fragmented and impacted the staff’s ability to work collaboratively and effectively in managing patients’ discharges from the hospital. Most staff confirmed the flow of the discharge process, and the lack of a multidisciplinary approach impacted staff working together and communicating effectively with each other and patients. 7 out of 16 patients told us they either did not know when they would be discharged or had all the details of the discharge arrangements.

While staff told us discharge co-ordinators were an invaluable resource, they had concerns that the effectiveness of the discharge process would be compromised further due to plans to centralise this team.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent and that they met both clinical expectations and the expectations of people themselves.

Assessment findings:

We found that patients mainly experienced positive outcomes as set out in legislation, standards, and evidence-based clinical guidance.

Specialist staff responded to the monitoring of patient outcomes by visiting identified wards where additional support and improvements were needed. For example, the falls team carried out a ‘hot’ debrief after any fall was reported. Staff told us this was useful in identifying immediate actions and learning to prevent future falls.

The service used clinical coding to support the delivery, planning and monitoring of patient care services and the planning and management of resources. The organisation’s Quality Accounts for the year ending 2024 demonstrated the service had achieved ‘Standards exceeded’ on the audit for the Data Security and Protection Toolkit.

Information we reviewed showed there were mechanisms to monitor and improve people’s care, treatment and outcomes were in place. Quality and safety priorities had been reviewed in April 2024. During this time, the service undertook reflections on what mattered to them and its patients. Links where possible were made to the strategic objectives and the service Quality Strategy. This enabled progress to be evaluated and included as part of the quality priority planning for 2024/25.

The Sentinel Stroke National Audit Programme (SSNAP) is a programme of work that aims to improve the quality of stroke care by auditing stroke services against evidence-based standards. The audit results between October and September 2024 showed an improvement in the hospital’s overall grade, from a B to an A. (The scores are between A and E).

The Summary Hospital Level Mortality Indicator (SHMI) is a standard and transparent methodology providing a set of data indicators to measure mortality outcomes across the NHS in England. The SHMI is the ratio between the actual number of patients who die at the service following hospitalisation and the number expected based on England’s averages and characteristics of patients treated. A risk score ratio is applied to reflect actual and expected numbers of adverse outcomes. A higher score means more adverse (worse) outcomes than expected. Between June 2023 and June 2024, the service’s score was slightly higher than the national average.

Consultant-led Referral To Treatment (RTT) waiting times monitor the length of time from referral through to elective treatment. The operational standard for the percentage of patients who are waiting less than 18 weeks was 92%. Patients waiting for elective treatment at Mid and South Essex were waiting longer as the service had been consistently lower than the national standard and average.

The service undertook quality monitoring audits to improve patient safety, outcomes, and experiences. These audits included monitoring incidents, trends, and levels of patient harm as well as identifying areas of further investigation. Information provided by the service demonstrated there had been an increased trend in nutrition and hydration incidents on some wards but a decrease in falls on the frailty unit and older people’s wards. All the audit results between January 2024 and December 2024 were above 80% with the majority being above 90%

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Assessment findings:

The Mental Capacity Act (2005) and Deprivation of Liberty Safeguards was implemented in line with legislation. Most staff understood and applied this legislation and the patient’s capacity and ability to consent was recorded in their clinical records.

We saw that do not attempt cardiopulmonary resuscitation (DNACPR) decisions made for patients were appropriate and in line with relevant legislation.

Sedation and the use of restrictive practices, such as mittens on patients were only used when deemed appropriate to do so. Appropriate documentation was available within 14 patient records viewed.

One patient’s relative told us that regular meetings with consultants enabled a full understanding of their relative’s care and treatment. We saw clinical records confirmed extensive discussion had taken place with the relative, providing updates and information to support informed decisions in their relative’s best interest.

During our SOFI observation, we saw staff requested consent from patients before providing personal care.