The Care Quality Commission (CQC) has published reports on Basildon University Hospital, Broomfield Hospital and Southend University Hospital, run by Mid and South Essex NHS Foundation Trust, following inspections that finished in November 2024.
These inspections were carried out in response to potential specific incidents and ongoing concerns over the safety of children and young people receiving care. Inspectors looked at children and young people’s services and urgent and emergency care (children’s emergency department) at each hospital.
Following these inspections:
- children and young people’s services at Basildon University Hospital have been rated inadequate overall. This was the first time this service has been inspected.
- children and young people’s services at Broomfield Hospital have been rated inadequate overall. This was the first time this service has been inspected.
- children and young people’s services at Southend University Hospital have dropped from good to requires improvement.
- urgent and emergency care with a focus on children’s emergency department was also inspected at all three hospitals. These services were not re-rated.
- All three hospitals remain rated as requires improvement overall.
Due to the level of concerns found during the inspection in services at all three hospitals, the trust has been issued a warning notice in April requiring significant improvements in governance and the safety of care for children and young people. The trust will submit an action plan in response to the notice.
Inspectors found in Children and Young People’s services at Basildon University Hospital:
- Staff were under severe pressure, often working without breaks in an overcrowded paediatric assessment unit where up to 20 children were cared for in a space designed for six.
- Inspectors found a backlog of paediatric discharge summaries and high numbers of children re-admitted soon after discharge, raising serious concerns about the effectiveness, continuity and safety of care.
- Staff didn't always feel supported by senior leaders and felt undervalued. They also didn't feel able to influence the future vision and values of the service.
- Families told CQC staff were kind, but inspectors found communication was poor, information wasn’t always tailored to children’s needs, and waits for treatment were too long.
- Inspectors found in urgent and emergency care that leaders didn’t always manage risks across the care journey effectively. Staff told inspectors the high level of demand and staffing shortages made it difficult to maintain oversight of young people and manage risks safely.
Inspectors found in Children and Young People’s services at Broomfield Hospital:
- Leaders had allowed a poor safety culture to develop where staff were afraid to raise concerns due to fear of reprisals.
- The trust didn’t ensure staffing levels and skill mix were sufficient to meet the needs of children and young people, and inspectors saw examples of unsafe early discharges leading to high re-admission rates.
- Young people and families told inspectors care between departments wasn't always timely, leading to long waiting times. They weren't always told what was going to happen and why.
- Some parents preparing their child for surgery said staff had familiarised them with one ward, only for the admission to be changed at the last minute, causing confusion and distress.
- Inspectors found limited evidence in urgent and emergency care that the service actively sought out, listened to, and responded to information about children and young people most likely to experience inequality in care or outcomes.
Inspectors found in Children and Young People’s services at Southend University Hospital:
- Leaders didn’t always provide staff with effective support or the skills needed to deliver safe care. They also didn’t ensure there were enough staff on duty with the high demand for the service, to keep young people safe. Senior leaders weren't always visible, and they needed to improve systems to make sure they had good oversight of risks.
- However, people described staff as kind and supportive, and families were involved in discussion about care and were able to raise concerns and were informed about their child’s care.
- Inspectors found demands in urgent and emergency care at Southend University Hospital was high, and leaders didn't always take timely action to mitigate risk to children and young people using the service.
- However, the majority of families told inspectors they felt informed and included in discussions about their child’s care, and that staff had listened to them and acknowledged their concerns.
Due to a large-scale transformation programme at CQC, the reports have not published as soon after the inspection as it should have done. The programme involved changes to the technology CQC used but resulted in problems with the systems and processes rather than the intended benefits. The amount of time taken to publish these reports falls far short of what people using services and the trust should be able to expect and CQC apologises for this.
While publication of some reports has been delayed, any immediate action that CQC needed to take to protect people using services has not been affected. CQC has taken urgent steps to ensure that inspection reports are published in a much more timely manner.