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Archived provider: Basildon and Thurrock University Hospitals NHS Foundation Trust Good

On 10 July 2019, we published a report on how well Basildon and Thurrock University Hospitals NHS Foundation Trust uses its resources. The ratings from this report are:

  • Use of resources: Requires improvement  
  • Combined rating: Good  

Read more about use of resources ratings

Inspection Summary


Overall summary & rating

Good

Updated 10 July 2019

Our rating of the trust stayed the same. We rated it as good because:

  • We rated safe and responsive as requires improvement. Effective, caring and well-led were rated as good.
  • We rated one of the trust’s four services we inspected as requires improvement and three as good. In rating the trust, we took into account the current ratings of the four core services not inspected this time. However, we also considered that the rating in Urgent and Emergency services within the safe domain had been in place since 2015. The trust presented updated information which meant it had a disproportionate effect on the trusts overall rating. Therefore, we have overridden the overall aggregation principles and rated the trust overall as good.
  • There were effective processes in place to ensure that learning from incidents was shared across divisions and embedded to minimise the risk of re-occurrence.
  • There were enough nursing and medical staff with the right mix of qualifications and skills, to keep patients safe and provide the right care and treatment. There were processes in place to address staffing shortages to deliver safe patient care.
  • Infection prevention and control policies and protocols were in place and regularly audited. Staff kept themselves and equipment clean.
  • There were effective systems and processes in place to conduct internal and external audits and teams acted on results.
  • There were robust processes in place to manage demand and capacity through performance monitoring and systems to manage access and flow.
  • The trust had developed a strategy to develop services in line with the over-arching strategy of a merger and clinical re-configuration. This meant that teams were able to link current activity to the trust’s future plans.
  • Managers worked hard to create a positive culture which was patient focussed and staff could raise concerns openly.

However, we also found:

  • Maternity services ratings for safe had declined from good to requires improvement. There had been a decline in safety practices in relation to women who were assessed as ‘high risk’ and the leadership team. The well-led rating for maternity services had declined from outstanding to requires improvement. There had been some changes in the leadership since our last inspection and the new maternity leadership team was developing.
Inspection areas

Safe

Requires improvement

Updated 10 July 2019

Our rating of safe went down. We took into account the current ratings of services not rated this time. We rated it as requires improvement because:

  • There was a decline in safety practices in maternity services. The service was caring for women deemed as ‘high risk’ in inappropriate areas without access to the right equipment or medical staff. As we did not inspect urgent and emergency care on this occasion, the rating for safe remained as requires improvement which has contributed to the overall rating for the trust in the safe domain.
  • Medical care, surgery and outpatient services were rated as good.

Effective

Good

Updated 10 July 2019

Our rating of effective stayed the same. We rated it as good because:

  • Medical care, surgery and maternity services were rated as good. Services continued to use evidence-based guidance to deliver care and treatment. Pain relief was monitored and managed in line with national guidance and teams used results from internal; and external audits to improve patient outcomes.
  • Outpatients was not rated in line with our methodology.

Caring

Good

Updated 10 July 2019

Our rating of caring stayed the same. We rated it as good because:

  • Medical care, surgery, maternity and outpatient services were rated as good. Staff continued to deliver compassionate care and treated patients and their loved ones with respect and dignity. Patients that we spoke with told us that staff had been caring and treated them with kindness.

Responsive

Requires improvement

Updated 10 July 2019

Our rating of responsive went down. We rated it as requires improvement because:

  • Surgery and outpatient services were rated as requires improvement. Although the trust had implemented a number of actions to improve performance in specific areas; patients could not always access initial treatment and assessment in a timely manner. This was a particular concern for patients awaiting initial treatment for cancers.
  • Medical care and maternity were rated as good.

Well-led

Good

Updated 10 July 2019

Our rating of well-led stayed the same. We rated it as good because:

  • The trust mostly had experienced leadership teams with the skills abilities and commitment to deliver the strategy and high-quality care. Managers across the trust generally recognised the training needs of staff at all levels and worked to provide development opportunities for the future of the organisation.
  • The newly developed trust strategy was directly linked to the vision and values and aligned to the over-arching strategy to merge with two other acute trusts and clinical reconfiguration. Staff were aware of the trust’s values and vision and how their actions contributed to delivering the strategy for the future organisation.
  • Managers across the trust were visible and approachable.
  • The trust had a clear structure for overseeing performance, quality and risk, with board members mostly represented across the divisions. There were clear escalation processes to follow when services needed more support.
  • Managers across the trust worked hard to promote a positive culture where staff and patients could raise concerns openly to improve patient safety and experience.
  • The trust engaged well with patients, staff, the public and local organisations to plan and manage appropriate services and collaborated with partner organisations effectively.
  • The trust was committed to improving services by learning from when things went well and when they went wrong, promoting training, research and innovation.

However.

  • In maternity services, the leadership team was relatively new and developing processes and systems. The Head of Midwifery and Clinical Lead met with the Chief Nursing Officer monthly but did not have direct access to the board to present to them regularly.
Assessment of the use of resources

Use of resources summary

Requires improvement

Updated 10 July 2019

Combined rating