The Care Quality Commission (CQC) has rated leadership at East Suffolk and North Essex NHS Foundation Trust requires improvement following an inspection in November 2025.
East Suffolk and North Essex NHS Foundation Trust provides hospital and community health services to almost one million people and is one of the largest NHS organisation in East Anglia. The trust delivers care from two main acute hospital sites, Colchester Hospital and Ipswich Hospital, six community hospitals and people’s own homes. The trust also provides community health services in east Suffolk and north Essex.
CQC carried out the well-led review following assessments of the trust’s front-line services. These initial assessments, which included urgent and emergency care and medical care at both Colchester and Ipswich, were triggered by concerns CQC received about risk within the services.
The trust was found to be in breach of one regulation in regard to good management.
CQC gives NHS trusts a single trust-level rating focusing on leadership and culture that replaces all other ratings at that level. CQC consulted on this approach and used feedback gathered to ensure this well-led key question at NHS trust level is appropriate for the new innovative, complex and integrated models of care being created.
Sarah Ivory Donnelly, CQC’s deputy director of hospitals in East of England, said:
“Our well-led review at East Suffolk and North Essex NHS Foundation Trust found that leaders understood the challenges facing their services, but they weren’t always quick enough to turn that understanding into action, putting people’s safety at risk.
“We issued warning notices at both Colchester and Ipswich after identifying significant risks to people’s safety. Leaders knew about these issues, but the actions they’d taken hadn’t gone far enough to reduce the risk of avoidable harm to the people in their care.
“Staff told us that executive leaders weren’t always visible across the organisation, and some said they wouldn’t feel safe raising concerns about senior leaders’ behaviour, worried that confidentiality would be breached given how closely the Freedom to Speak Up guardian works with the chief executive and chair. This had the potential to cause tension among leaders and staff and needs to be addressed.
“We also found gaps between the trust’s ambitions and what leaders were actually delivering day to day. Despite a clear strategic focus on quality improvement, we didn’t see consistent evidence that this was being embedded by leaders across the organisation, and repeated findings across successive inspections raised questions about whether they were learning from what they’d been told before.
“It was also concerning that leaders hadn’t made significant progress on workforce equality over the last five years, with black staff and staff from ethnic minority groups continuing to report a worse experience than their white colleagues.
“On a more positive note, leaders had a clear shared vision and values for the trust and worked collaboratively with partners across the system to tackle shared challenges like mental health service capacity.
“We’ve shared our concerns directly with the trust’s leadership. They understand what’s required of them, and we’ll continue to monitor their progress closely to keep people safe while they make these changes.”
Inspectors found:
- The trust didn’t always have clear roles, responsibilities, systems of accountability or good management resulting in weak oversight and decision-making.
- Leaders didn’t ensure that audit and management systems were consistently effective in driving sustained improvement across services. For example, audits of people’s basic needs, such as nutrition and hydration charts weren’t consistently completed in line with policy, putting people at risk of harm.
- The trust worked in partnership with other healthcare organisations, but these arrangements didn’t consistently result in timely and effective care. For example, while the trust worked collaboratively with the local mental health trust, people with mental health needs faced delays in accessing support while in A&E, and staff didn’t always feel qualified or able to meet their needs during these times.
- Leaders tried to ensure there was a culture of openness and transparency, but prior to our trust level assessment some staff told us this wasn’t always consistent.
- The trust didn’t always focus on continuous learning, innovation and improvement across the organisation and local system. Leaders didn’t always encourage creative ways of delivering equity of experience, outcomes and quality of life for people.
- Leaders understood their duty to collaborate, and the trust was an active partner in the development of Integrated Neighbourhood Teams in both Suffolk and North East Essex, to improve joined up, person-centred care.
- Leaders were aware of the trust’s impact on environmental sustainability and provided examples of where the trust had made changes to reduce its carbon footprint.