- NHS hospital
Basildon University Hospital
Report from 25 April 2025 assessment
Contents
Ratings - Urgent and emergency services
Our view of the service
This is the first full assessment for this service since it was merged in April 2020. We carried out this short notice assessment of the urgent and emergency care service as part of the system pathway pressures assessment programme between 17 and 18 December 2024. We undertook another site visit on 8 January 2025 to follow up the concerns we found on 17 and 18 December 2024 and, due to ongoing concerns we, visited again on 10 March 2025. We inspected all 34 quality statements across the 5 key questions, safe, effective, caring, responsive and well-led for urgent and emergency care department.
During this assessment, we visited the emergency department (ED). We reviewed the environment, staffing levels, looked at care records and prescription records. We spoke with staff members across various grades and patients and observed meetings. We reviewed performance information about the trust and observed how care and treatment was provided.
We rated safe and well-led as inadequate because people were at risk of serious harm and the leadership, oversight and governance was not effective in keeping people safe. We rated effective, caring and responsive as requires improvement.
As a result of this assessment, we served a Section 31 notice to impose conditions on the provider’s registration because people would be at risk of harm if we did not take this action. We found 2 breaches of the legal regulations in relation to safe care and treatment and governance. We requested an action plan to address these concerns.
We found significant concerns with the safety and quality of the service which meant patients were at risk of ongoing harm. We found a disjointed leadership team and a culture of distrust and low morale amongst staff. Systems to identify and manage risk were not effective and did not lead to improvements for patients. There was not a positive learning culture and staff were not always involved in making decisions about how to improve the service and were not given key information about concerns.
Whilst staff within the department in the same role worked well together, the service did not always work well with other teams and system partners. Nursing staff were not empowered to make referrals by medical staff which contributed to the overcrowding and delay to patient care.
Patients were at risk of ongoing harm. The queuing system for patients entering the department was confusing and led to delays for patients. A lack of clinical oversight in the waiting room meant there was a risk patients could deteriorate without staff noticing. There were not enough staff with appropriate skills to safely assess or meet patients' needs or the clinical demand in the department.
People's experience of this service
Patients were not always treated with kindness, compassion and dignity. Patients did not always have care tailored to meet their needs and did not always have adequate food, fluid and pain relief. Feedback from patients was mixed, many patients commented staff were doing the best they could under significant pressure, but some people reported a poor experience in the service.