Basildon University Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Assessment findings:

We looked for evidence that the service met people’s needs. We assessed three quality statements.

At our last inspection we rated this key question good. At this inspection the rating has remained good.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Patients were mostly at the centre of their care, treatment and support. Staff worked hard to provide equity in access. However, the significant working pressures sometimes impacted how well people could access care, treatment and support when they needed it.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service worked hard to make sure people were at the centre of their care and treatment choices and they worked in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Assessment findings:

We saw evidence of some good conversations taking place with relatives to ensure they were kept informed of the care and treatment options and thorough assessments and action plans completed by therapy teams including patient's expectations of care and the outcomes of the treatment.

There were mixed views from patients and relatives about their experiences of receiving person centred care. Most patients spoke of being involved in and receiving good standards of care and treatment that met their needs. Whereas some patients and relatives expressed concerns about not being effectively involved in making shared decisions and receiving inconsistent information.

We found person centred care planning was mostly taking place in patient records, with patient's individual needs being recognised and met.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The service mostly met the accessibility information standards and supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Assessment findings:

The service mostly supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. For example, the service offered a variety of systems and ways of communicating with patients. These included an interpreter service for people whose first language was not English and information leaflets in different languages, text messaging appointment reminders, virtual video appointments, a Patient Knows Best portal for patients aged over 16, and NHS Wi-Fi. This free Wi-Fi service enabled access to multiple health and care systems and a more equitable system to access healthcare.

To support patients living with dementia or cognitive impairment in their environment, we saw large picture signs on doors to help them identify their surroundings.

Patients who were placed in additional care spaces under the full capacity protocol were given information leaflets to explain the reasons for this. Though some patients and relatives told us they did not always feel informed about their care and treatment, ward moves and discharge arrangements.

Staff had access to information about patients’ needs within paper and electronic records. However, data protection legislation requirements were not always followed as some central monitoring screens displayed patient identifiable information in public areas.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

Assessment findings:

The service had an awareness of the populations’ needs and where discrimination and inequalities could disadvantage different groups of people. Coproduction with the local population and communities supported the development of a shared vision and strategy with 6 strategic objectives. Two of these objectives complemented key priorities in the Equality Diversity and Inclusion Strategy 2021-2025 to improve access and population health outcomes.

Staff worked hard to remove barriers and give patients equal access to care and treatment; they liaised with other healthcare professionals to provide timely service for different healthcare needs and serious conditions needing specialist input.

However, mechanisms to promote accessible, timely care, treatment, and support in line with best practices, quality standards, and legal requirements were not always effective.

Patients told us they could access care, support and treatment, although they sometimes faced delays. One patient who was being cared for under the full capacity protocol told us they had been waiting for appropriate equipment to support their tissue viability, but this had not been available until a bed space was available for them. We saw in this patient’s records that this had happened and also within another patient’s record.

The significant patient flow pressures sometimes impacted the ability to provide patients with timely access to care, treatment, and support. The frailty same-day emergency care pathway was designed to support patients to be assessed, discharged with admission avoidance, admitted to another ward area or receive follow up care. The service reported that frailty same-day emergency care pathway activity numbers were not being captured, but they were taking steps to rectify this.

During our inspection, we found the same-day emergency care unit was not always able to function within its intended purpose. This was because it was being used for overnight inpatient beds. This impacted patient’s coming into the unit as an outpatient to receive further care post discharge.

Lionel Cosin ward had a designated area for patient assessments directly from the emergency department, the neurology rapid access clinic, and outpatients. However, staff told us they had difficulty in delivering and expanding the service as outlined in their business plan due to winter pressures and the need for additional beds. They told us that patients had stayed in the designated assessment area overnight and even days in some cases.

Staff told us doctors did not visit the short stay/discharge lounge regularly, so if a patient needed a review whilst on this unit there was no set process for doctors to follow and that getting a patient medically reviewed who required escalation could be challenging. This was a risk to patients when they remained on the ward overnight or for longer periods.

Information provided by the trust showed that there was a shortage of medical beds and a number of patients placed on wards that were not best suited to meet their needs (also known as outliers). Information provided by the service following our inspection demonstrated the number of medical outliers being captured. However, we did not hear medical outliers being discussed during our attendance at the bed management meeting. We were therefore not assured that outliers were being monitored effectively to ensure patients received a medical review daily.

There were times when patients did not have reasonable access to beds on specialty wards as they had to move wards for both clinical and non-clinical reasons. This could impact timely care and treatment being provided to these patients. While the service tried to move patients earlier in the day, the information provided by the service demonstrated there were a significant number of patients mainly from acute medical units and some from the frailty unit who were moved between 6 p.m. and 8 a.m. Between July and December 2024 records showed there had been 6565 patient moves within hours and 2108 patient moves out of hours.

The service had closed 2 step-down frailty wards on a satellite site (50 beds) as they felt the additional moves for patients increased the risk of deconditioning and increased length of stay. Leaders reported that on the day of inspection, there were 16 delayed patients and 52 medically optimised patients waiting for social care beds. Leaders described variance in availability for discharge to assess beds across different local authorities. Access to these beds was coordinated by the system director based within the service.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.