East Surrey Hospital

Updated 4 November 2026

Date of assessment: 9 to 12 March 2026. 

East Surrey Hospital is part of Surrey and Sussex Healthcare NHS Trust. The trust is a provider of acute hospital services in West Sussex and East Surrey, offering care to a local population of 744,000 people. The trust also provides care to people from further afield due to the proximity to transport connections. It provides a range of NHS hospital services. 

This assessment looked at urgent and emergency care and medical care. We carried out these assessments as part of the CQC winter pressures programme and due to increased concerns in both areas. The service also had previous breaches in legal regulations relating to safe care and treatment, and governance. 

We rated both urgent and emergency care and medical care (including elderly care) as requires improvement.

The ratings from urgent and emergency care and medical care (including elderly care) have been combined with ratings of the other services from previous inspections, to give an overall rating for East Surrey Hospital. See previous reports to get a full picture of all other services at East Surrey Hospital. 

At this assessment we found breaches of regulation in urgent and emergency care, in relation to safe care and treatment, premises and equipment, staffing and good governance. We also found breaches of regulation in medical care (including elderly care), in relation to safe care and treatment, premises and equipment, staffing and good governance. 

The rating of East Surrey Hospital has remained requires improvement. 

Updated 18 November 2025

Date of assessment: 11-12 March 2026. 

We carried out an announced assessment of medical care (including older people’s care) due to increased concerns and previous breaches in legal regulations relating to safe care and treatment, and governance. 

During our assessment, we found concerns which resulted in breaches of regulation. We found breaches in regulation relating to safe care and treatment and governance. You can find more details of our concerns in the evidence category findings. We rated the service as requires improvement. We found 4 breaches of the regulations in relation to safe care and treatment, premises and equipment, staffing and governance. 

Staff did not always assess and mitigate risks to people’s health and safety when identified. Leaders did not consistently maintain effective oversight of patient care. While many staff reported feeling supported by their immediate managers, low staffing levels negatively impacted morale, and learning from incidents was not always shared effectively across the service. The premises and facilities did not consistently meet the needs of patients or support the delivery of care. Governance arrangements were not sufficiently effective to support the delivery of safe, high-quality care. Patient confidentiality was not always protected. 

However, staff were caring and kind toward patients and tried to mitigate risks where possible. Staff remained committed to delivering good care and mitigating risks where able. Staff demonstrated a strong commitment to safeguarding and teamwork. Leaders displayed compassion and understanding of the challenges impacting the service. Leaders understood the actions required to improve care and patient safety.

Following the assessment, CQC issued a Section 29a Warning Notice to the trust due to concerns about the delays in patient assessment and treatment, the safety and oversight of corridor care and weaknesses in the governance arrangements. The trust responded with an improvement action plan to address the concerns identified.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.

Updated 18 November 2025

Date of Assessment: 09–10 March 2026 

We carried out this assessment due to increased concerns in the emergency department and as part of the CQC winter pressures programme.  We assessed 32 quality statements across the safe, effective, caring, responsive and well-led key questions. We found the quality of care had declined.  

At the last assessment in October 2018 the service was rated as good and there were no breaches of regulation.  

At this assessment we rated the service as requires improvement.  We found 4 breaches of the regulations in regulation in safe care and treatment, premises and equipment, good governance, and staffing.  

At this assessment we found the service was operating under sustained and significant operational pressure. Overcrowding, poor patient flow and delays accessing onward care had become embedded challenges within the department and adversely affected the delivery of safe, effective and responsive care. Patients were routinely cared for in inappropriate environments, including corridors and waiting areas, often for prolonged periods. Systems to assess, monitor and respond to patient risk were not consistently effective, which resulted in delays to triage, assessment, treatment and the recognition of deterioration. Medicines were not always managed safely, and medicines management systems did not consistently support the safe delivery of care. Staffing levels, skill mix, deployment and the environment did not consistently support the safe delivery of care. As a result, patients, particularly those with mental health needs, children and other vulnerable groups, were exposed to increased risks and did not always receive care in environments that met their needs. We found the service did not consistently deliver timely, effective or person-centred care. Delays in accessing assessment, treatment, inpatient beds and specialist services affected patient outcomes, continuity of care and patient experience. Whilst leaders understood the challenges affecting the service and there were governance arrangements to monitor quality, safety and performance, several longstanding concerns relating to patient flow, corridor care, capacity pressures and wider system demand remained unresolved. The service routinely identified, monitored and escalated risks. However, it was unable to consistently demonstrate that actions taken resulted in sustained improvement or timely resolution of longstanding concerns. Whilst leaders understood the challenges affecting the service, some leaders did not feel fully involved in decisions affecting the department and lacked confidence that concerns raised through organisational processes would consistently result in meaningful change.

However, staff remained committed to delivering good care despite the significant pressures they faced. Patients consistently spoke positively about the kindness, compassion and professionalism of staff. Staff worked collaboratively across teams and with partner organisations to support patient care and demonstrated a strong commitment to safeguarding, learning and improvement. Departmental leaders were visible and supportive, and staff described a positive team culture despite the challenging environment. There were effective systems to support safeguarding, incident reporting, risk monitoring, patient feedback and partnership working, and leaders demonstrated a good understanding of the challenges affecting the service and the actions required to improve care.

Following this assessment, CQC issued a Section 29A Warning Notice to the trust due to concerns about the timeliness of patient assessment and treatment, the oversight and safety of patients cared for in waiting areas and corridors, the provision of emergency care for children and young people and people experiencing mental ill health, and weaknesses in governance arrangements supporting the delivery of safe care. The trust responded with an improvement action plan which included immediate actions to address these risks, alongside longer-term actions to improve patient flow, governance, staffing and operational oversight.

The Warning Notice focused on concerns requiring urgent action to reduce the risk of harm to patients. The full assessment considered a broader range of evidence across all quality statements and regulatory requirements. This identified areas where the service was not consistently meeting the fundamental standards and resulted in breaches of Regulations 12, 15, 17 and 18. We have therefore requested that the trust submit an action plan setting out the actions it will take to address these identified breaches.

Updated 8 June 2014

Services for children and young people were good. Most children and parents told us the staff were kind and attentive; the staff were described as ‘lovely’ and ‘funny’. Ward areas and equipment were generally, clean and appropriate infection control measures were in place. There were enough trained staff on duty to ensure that safe care could be delivered. There were thorough nursing and medical handovers that took place between shifts to ensure continuity of care and knowledge of patient needs.

Younger children received very good inpatient care and the ward was resourced to ensure their wider needs were met. Good facilities and staff support encouraged a parent to stay in hospital with their baby or child. The quality of care of adolescents was limited by the accommodation; we observed instances where the privacy and dignity of teenagers was not respected. The care on the neonatal intensive care unit was outstanding. The staff team were committed to ensuring best practice and optimal care for the babies admitted to the unit.

Senior staff communicated well and staff were positive about the service. There was clear evidence that the wider multidisciplinary team worked well together for the benefit of the younger patients. Children’s experiences were seen as the main priority. Staff felt supported by their managers and were encouraged to be involved in discussing their ideas for improvements.

Updated 8 June 2014

Patients we spoke with gave us examples of the good care they had received in the unit. The leadership of the unit created a culture of reporting and learning from incidents. There was good multidisciplinary working to ensure patient needs were met. Guidance form recognised professional bodies were followed and audited to ensure their effectiveness.

Patients were treated with compassion, care and dignity. The service demonstrated responsiveness to the needs of patients and the local population. Changes were being made to the management of high dependency unit (HDU) to improve patient flow through the service.

Updated 8 June 2014

We found that the trust had systems in place to ensure end of life care was safe and met the needs of patients and that staff were committed to providing person centred care to patients who were receiving end of life care. Patients spoke positively about the way they were being supported with their care requirements. Relatives also spoke very positively in regard to the support they and their relatives received.

The specialist palliative care team were responsible for ensuring that end of life care was delivered to staff within the ward areas as part of their mandatory training. The specialist palliative care team had developed an end of life care pathway tool which was in use in all the ward areas we visited. Staff in all of the ward areas we inspected were aware of the tools used for patients receiving end of life care and all staff were aware of how to contact the specialist palliative care team.

Updated 15 November 2023

Updated 18 January 2019

Our rating of this service improved. We rated it as good because:

• Staff received effective training in safety systems, processes and practices and understood how to protect people from abuse and their responsibilities regarding the Mental Capacity Act 2005.
• Standards of cleanliness across the department were maintained. There were systems in place to monitor and audit infection control activities.
• The design, maintenance and use of facilities and equipment kept people safe. Equipment was maintained and monitored to ensure it was fit for use.
• People’s individual care records, including clinical data was written, stored and managed in a way that kept people safe. The management of medical records had improved since our previous inspection.
• Medicines in outpatients were managed safely. Medicines and prescription pads were kept locked when not in use.
• Lessons were learned and improvements made when things went wrong. Issues were discussed in daily safety huddles where improvements were identified and shared.
• The service provided care and treatment based on national guidance. Speciality clinics operating within the outpatient department followed relevant national guidance and participated in national and local audits.
• The service made sure staff were competent for their roles. There were induction arrangements for new staff and the department’s compliance with appraisal rates exceeded the trust target.
• Staff gave patients enough food and drink, where appropriate, to meet their needs whilst in the outpatient department.
• People were treated with compassion, kindness, dignity and respect, when receiving care. Staff communicated with people in a way that supported them to understand their care and treatment.
• A working group to review access to the department for patients with physical and learning disabilities was in operation.
• The facilities and premises were accessible to patients and clearly signposted. Where there were limitations on space within waiting areas staff acted to mitigate risk and the trust was working to improve the environment. Signposting within the department had improved since our previous inspection.
• The ‘did not attend’ rate for the outpatient department at East Surrey Hospital was better than the national average.
• People had timely access to initial assessment, test results and diagnosis and treatment. Referral to treatment times were monitored and performance for non-admitted and incomplete pathways had improved and was better than the national average in recent months.
• Trust performance for cancer waiting times was better than the operational standard and the national average in the most recent two quarters.
• Data showed that the proportion of cancelled clinics within outpatients had reduced.
• There was evidence of learning and improvement from complaints. Complaints were responded to in line with the trust’s complaints policy.
• Leaders were visible and there was a clear vision and set of values, with quality and sustainability as the top priorities. An outpatient strategy had been developed in line with the trust strategy.
• Staff and leaders alike reported that the culture within the service had improved since a previous inspection when staff reported feeling frustrated and not listened to by managers. Staff told us they felt valued.
• There were governance structures and processes to manage current and future performance and robust arrangements for identifying, recording and managing risks, issues and mitigating actions.
• There were clear and robust service performance measures which were reported and reviewed.
• The trust had systems and processes in place to engage with patients, staff, the public and local organisations to plan and manage services.
• There were standardised improvement tools and methods, and a trust-wide continuous improvement approach in operation within the outpatient department.

However;

• Patients undergoing minor surgical procedures within the outpatient department were not giving consent until they were in the procedure room which was not in line with best practice.
• In some outpatient areas there was limited space for private conversations to be held with patients, including those where bad news was being delivered.
• Toys in the department were not subject to routine cleaning schedules.
• Resuscitation equipment within the cardiac clinic was subject to daily and weekly checks but there were some gaps in the recording of these.

Updated 18 January 2019

Our rating of this service improved. We rated it as outstanding because:

• The management of medicines was good. Cupboards on the wards were well stocked, locked and labelled correctly. Medicine cupboards in theatres were also well stocked and medicines that were coming up to their expiry were marked to show this. We checked ten different packs at random and they were all in date.
• There was a strong incident reporting culture in the surgical division where staff felt comfortable to report incidents as there was a no blame culture. Staff we spoke with described how details of incidents were communicated in weekly messages from the chief of surgical services. They were then further shared and discussed in team safety huddles for those that hadn’t yet seen the messages.
• Staff we spoke with had a good awareness of how to manage suspected sepsis following a wide-ranging review that had been carried out by the service.
• Patient’s pain was managed well and pain relief was given when required. The surgical division had access to a dedicated pain team, seven days a week.
• Patients had a lower expected risk of readmission for elective admissions when compared to the England average. Patients at the trust also had a lower expected risk of readmission for non-elective admissions when compared to the England average.
• We observed many interactions between staff, patients and relatives. We saw that patients were treated with compassion. We heard examples of how staff, on different wards had gone the extra mile to do things for their patients.
• A number of other patients told us how the staff were all compassionate and did what they could for them. We also looked at some of the thank you cards that had been received across the surgical wards. These described how they or their loved ones had been cared for during their time in hospital and offered heartfelt thanks to the staff.
• Surgery services were planned around the needs of the local population. Patients were treated as individuals and the care provided reflected this.
• Complaints were fully investigated and responses reflected this. There was clear evidence that learning was taken from complaints and that learning was shared with the complainant.
• The surgical division was led by a triumvirate comprising the Chief of Surgery, the Associate Director, Clinical Services and the Divisional Chief Nurse.
• We found that they were an effective, cohesive team that were aware of their strengths and weaknesses.
• The surgical division had a well-defined governance structure. This was overseen by the Surgical Divisional Board. The aim of the Surgical Division board was to ensure local accountability for performance and risk management through regular review of its governance processes and oversight and review of local risk registers, incidents, complaints and clinical audit processes to ensure oversight and management of risks were well established. The service had had to close two theatres for major refurbishment in the summer of 2018. In response to this they had been able to build two temporary theatres and have them fully operational within four weeks.
• The service had a comprehensive risk register. This identified risks and categorised them using a Red, Amber, Green (RAG) system, defined by a method of scoring the risk by the likelihood of it happening and the impact.

However,

• The trust set a target of 80% for completion of mandatory training. Although compliance had been achieved in 24 out of 29 courses, it was considered that a trust target of 80% was low.
• Ambient temperatures were not being monitored in any of the clinic rooms where medicines were stored.
• General surgery and ophthalmology patients at East Surrey hospital had a higher expected risk of readmission for elective admissions when compared to the England average.
• Ear, nose and throat (ENT) patients at East Surrey hospital had a higher than expected risk of readmission for non-elective admissions when compared to the England average
• The Friends and Family Test response rate for surgery at Surrey and Sussex Healthcare NHS trust was 22% which was worse than the England average of 27% from July 2017 to July 2018