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

At this assessment we rated this key question as requires improvement. This meant people needs were not always met.

The service did not always make sure people could access timely care, support and treatment when they needed it. There was crowding in the department from both increased patient numbers, but also the unmet demand for ward beds for emergency department patients in a hospital often at full capacity. Patients also remained on ambulances for several hours with the crew unable to return to patients in the community.

People’s individual needs were not always recognised and supported. Care plans and assessments we reviewed did not always reflect the patients physical, emotional and social needs. Patients living with dementia were accommodated out of sight of nursing staff and there were very limited dementia friendly initiatives for patients in the department.

The service did not always act on feedback from patients to improve the service and where patients had made a formal complaint the actions taken had not always led to improvement in care for patients. However, the service did offer apologies where it had recognised a need for improvement and gave feedback to people who made complaints.

Whilst the trust had identified in their strategy the need to engage with communities to design services, we did not see any evidence the service had worked with local community groups to deliver services tailored to the local population needs.

The service provided information to patients in a way they could understand and met the Accessible Information Standard (AIS). The service also offered a variety of ways of communicating with patients.

This service scored 57 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People’s individual needs were not always recognised and supported. We reviewed several assessments and care plans and found they were not always reflective of people’s individual physical, emotional, and social needs. This meant there was a risk that staff may not respond to any relevant changes in people’s needs.

We also observed patients living with dementia or confusion and were accommodated in seated areas or out of sight of nursing staff. This meant, staff were not always able to see when patients required help and, on some occasions, the assessment team had to intervene to help patients living with dementia to stop them hurting themselves.

The lack of permanent learning disability specific staff members created a risk that patient care for this patient group, would not be as person centred as it could have been.

Staff told us there was access to a quiet room if an autistic person or person with a learning disability needed it. This was important as individuals with autism and learning disabilities can experience sensory overload, where their senses become overwhelmed by external stimuli.

The provider had a range of religious support facilities and ways in which patients' faith could be supported if needed.
Digital flags could be added to patient records to highlight if the patient had specific needs. There was a flag available for patients living with dementia but no way to highlight if a patient had a learning disability.

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 supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The urgent and emergency care patient survey showed patients rated staff explanation about why tests needed to be carried out, the results of tests and information provided about the same as other services. However, patients rated the information provided more helpful than average to help them care for their condition at home.

The service offered a variety of systems and ways of communicating with patients. These included a text messaging appointment reminder, virtual video appointments, a digital health platform designed to give patients more control over their health information and care portal for patients aged over 16, and NHS Wi-Fi. This enabled access to multiple health and care system and a more equitable system to access healthcare.

The Accessible Information Standard (AIS) is a legal requirement introduced in 2016 to ensure that adults and children who have a disability, impairment or sensory loss receive information in a way that they can access and understand, and any communication support that they need is identified, recorded and provided. Information provided by the service met this standard.

Whilst we observed and staff told us there were processes to translate information for patients, their families and carers into different languages and staff knew how to access these. Staff also told us they were regularly unable to get support in the language they required. The service had no oversight of this concern as there were no audits as to the interpreting services effectiveness.

The trust’s latest CQC urgent and emergency care survey (2024) showed patients’ experiences were worse than the NHS national average for being informed about the length of waiting times. We observed there were no facility to inform patients of waiting times for triage or to be seen by the doctor. This was also highlighted as a concern from patients in the friends and family survey data.

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.

The service did not always make sure people could access timely care, support and treatment when they needed it. There was crowding in the department from both increased patient numbers, but also the unmet demand for ward beds for emergency department patients in a hospital often at full capacity. We saw patients were not always streamed to the correct area of the hospital. During our assessments, a significant number of patients had already seen their GP and some had a referral letter, but they were often not referred directly into services within the hospital.

People also remained on the back of the ambulance that brought them for many hours with the crew unable to handover the patient and return to the needs of the community.

The trust outlined in their 2024 winter plan that they would ensure these patients were seen by the same day emergency care (SDEC). However, we did not observe this happening in practice. We saw patients who could have been referred directly from the navigator nurse to surgery or medicine, in line with procedures, who were sent to triage instead. This meant there was a risk that access to timely appropriate services was compromised. We found that one of the reasons was that SDEC was being used for overnight beds due to an increased demand for beds in other services.

The provider limited patients’ ability to have equal access to care, such as a lack dementia friendly decor including that for accessing the date and time. There was also very limited information to support any person with a learning disability.

On speaking with patients, we found 1 person had been sat in a wheelchair for 17 hours and staff had not sought more comfortable seating arrangements or asked them if they were able to access and use toilet facilities. The patient said, “17 hours in this chair is torture.”

Inappropriate areas were being used to care for patients because demand had outstripped capacity. The staff were trying their best to find places to put people, but areas were not being risk assessed to try and ensure the safety of the patient. Areas were used that did not have access to medical gas, and staff didn't have the physical space to move monitoring equipment or respond quickly in the event of an emergency.

Similarly, we observed, and patients told us they were being asked to stand in the waiting room after seeing the doctor and receiving treatment because there were no beds available in the department and no chairs available in the waiting room. We did not observe staff ensuring patients in the waiting room had seats.

The trust included information on accessibility on their website and this included Basildon hospital but there was no specific information available for Basildon hospital. We saw the trust website included a video for patients on what to expect when attending the emergency department and this was particularly focussed on patients with additional needs. However, this was filmed at another hospital site within the trust so although it may be viewed by patients at Basildon, it was not specific to the hospital.

The provider’s February 2025 board paper statistics showed that for Urgent and Emergency Care (UEC), the December 2024’s performance deteriorated by 6.1% to 62.8% against the 4-hour standard. This was worse than same month for 2023 (65.2%). Challenged performance had been driven by high acuity, high flu demand and norovirus outbreaks at Basildon and Broomfield hospitals. Average ambulance handover time worsened to 37 minutes, however, this remained in line with same month in 2023 (34 minutes). The ICB had implemented a new ‘Flow and Discharge Cell’ with responsibility for supporting patient flow and hospital discharges across the system. Medically optimised and delayed discharges improved to 126 patients (trajectory 140 patients). This was the lowest since December 2021.

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.