East Surrey 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

We assessed a total of 4 quality statements from this key question. We have combined the scores for these areas with scores based on the rating from the last inspection, which was good. Our rating for this key question good.
We found people received care, treatment and support that was in line with legislation and current evidence-based good practice and standards. Staff reviewed people’s care and treatment by assessing and reviewing their health, care and wellbeing. Staff worked well across teams and services to support patients. The service monitored people’s care and treatment to help improve outcomes, however it was unclear how this information was used effectively and communicated throughout the service.
 

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.

Patients generally felt informed about their care, and felt staff assessed their individual needs.

Staff told us when patients were admitted to their wards, they would look at care plans, read patients notes and talk to the patients to understand their health, care, wellbeing and communication needs. If they felt anything was missing, they would contact medical staff or senior clinical staff to address.
Staff reviewed and up-dated patient’s care needs during ward rounds and handovers.
 

We observed ward rounds and handovers where patient’s patients, care, treatment and progress were discussed. Changes to care and treatment were made at this time if required. Patient’s needs were assessed using a range of assessment tools to ensure their needs were reflected and understood.

Patients generally felt informed about their care, including ward transfers and changes in treatment. Some patients expressed uncertainty about discharge plans and whom to contact for complaints.
There were some concerns raised about mealtimes and staffing levels, particularly regarding food distribution.
 

Staff told us multidisciplinary teams were involved in clinical reviews and medical committees to make sure patients were receiving the right care at the right time and care and treatment was safe and effective.

The service had up-to-date policies and procedures to ensure care and treatment was delivered in line with national guidance and best practice. Policies we reviewed referenced national guidance. However, there were gaps seen. For example, there was no policy or standard operating procedure relating to patient risk assessments and admission to the service.
Staff could access policy documents on the hospital’s database. These measures ensured staff working in the service had access to up-to-date practices to provide safe care to patients.
The service completed a range of internal and external audits throughout the year to ensure healthcare was provided in line with their policies, national guidance and standards. The hospital shared audit results and post audit action plans with us to evidence standard of care and treatment at the hospital.
Clinical effectiveness was reviewed and discussed at various hospital meetings.

Patients told us other health professionals were involved in their care such as physio and occupational therapists and worked together with the doctors and nurses to treat their illnesses and help them recovery.

Staff explained all care pathways were multi-disciplinary and staff of all disciplines developed and supported each other in the planning and delivering of patient care. Each professional group recorded their assessments in the electronic patient records which meant it was easy to access information about the outcome of the evaluation and the ongoing care of the patients from each professional’s perspective.

We observed good multidisciplinary team (MDT) working throughout the medical care service. MDT working was an embedded practice which helped delivered a joined-up approach to delivering care and treatment to the patient. We observed teams working together to deliver care and treatment.

There were MDT ward meetings, handovers and ward rounds throughout the medical care service where patients, care, treatment and progress were discussed daily. This meant it was easy for staff to share information between teams and services to ensure continuity of care.

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.

Patient feedback results between September 2023 to August 2024 showed 90% of inpatients across the service had a positive experience at the hospital. The response rate was unknown but data was based on 147 responses.

Staff told us the service did not use a performance dashboard to monitor ward performance. Information, including audits results had to be gathered from different systems. Not all senior staff could tell us about their performance and risk data for the areas they worked in. Divisional leaders said this made it difficult to provide real-time data and insight for quick detection and resolution of performance issues.
Staff told us there was no internal ward accreditation scheme. These schemes have been shown to engage staff and empower leaders to improve standards and quality on adult inpatient wards.
 

Data was collected and a range of meetings held to monitor performance and outcomes in the service. However, it was unclear how systems and processes worked together to give oversight and disseminate information to the teams at ward level to give oversight of performance and outcomes at ward level.

The service collected participated in national benchmarking clinical audits. This allowed the trust to benchmark their clinical outcomes with peer organisations and use the findings to improve standards or highlight their achievements to patients. Post inspection we asked to see the action plans in response to 8 national benchmarking audits. We received 4 up to date audit results and their action plans which were to be used to drive improvement. However, for 3 of the benchmarking audits, the information received was not current but dated back to 2020/2021. and for one audit, the national respiratory audit programme, we received no information. Therefore, we could not be assured that the service was effectively using national benchmarking clinical audits to review performance and improve quality of care for patients.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.