Surrey and Sussex Healthcare NHS Trust

Ratings - Well-led

• Well-led Our assessments of NHS trusts now focus on leadership. We no longer rate trusts overall for their safety, effectiveness and responsiveness or how caring they are. We do still publish those ratings for the services they provide.

  Requires improvement

Our view of the service

Surrey and Sussex Healthcare NHS Trust provide a comprehensive range of emergency and non-emergency services to the residents of East Surrey, West Sussex, and South Croydon, including the major towns of Crawley, Horsham, Reigate, and Redhill. The trust runs East Surrey Hospital in Redhill, with more than 700 beds and provides acute and complex services. In addition, the trust provides a range of outpatient, diagnostic and less complex planned services at The Earlswood Centre, Caterham Dene Hospital, Crawley Hospital and Horsham Hospital. Each year, the trust sees over 100,000 people in their emergency department, deliver nearly 5,000 babies and over 400,000 people have outpatient appointments. The trust is a major local employer, with a diverse workforce of around 5,000 staff providing healthcare services to a growing population of some 744,000 people.

The Chair joined the trust in November 2024 and has since supported the establishment of a full complement of experienced Non-Executive Directors. The Chief Executive took up post in September 2025, shortly before the trust-level assessment of well-led.

We assessed the whole well-led framework (all 8 quality statements).

The trust level assessment followed assessments of the trust’s front-line services (assessment service groups - ASGs). The locations and ASGs we assessed included medical care at East Surrey Hospital and outpatients at Crawley Hospital. We undertook these assessments to ensure we had a thorough understanding of services provided by the trust ahead of our trust level assessment. The initial assessment of the trust’s front-line services was triggered in response to information of concern we received associated with risk within the services.

We found breaches in the regulations in relation to good governance. The oversight and management of risk was not robust, and governance arrangements were still embedding. Staff did not feel able to speak up and there was a lack of psychological safety. While there was a culture where equality, diversity and inclusion mattered, work was still needed to improve the experiences of staff.

We identified areas for improvement within 6 of the 8 quality statements and positive findings within 5 of the 8 quality statements.

While the trust board maintained comprehensive structures and regular reporting to oversee culture, leadership, and workforce equality, significant gaps remained between formal governance assurances, and the lived realities of staff.

The trust had a clear vision and strategy centred on transparency, equity, inclusion and meaningful engagement, but this was not reflected in its culture. Leaders did not consistently model organisational values. Staff did not all feel there was a culture based on transparency, equity, equality and human rights, diversity and inclusion, Staff did not all feel able to speak up or feel confident they would be heard.

Governance arrangements were not yet fully embedded and were not always effective at all levels. Leaders did not use the best information on risk, performance or outcomes, and although staff reported better understanding of risk principles, this was not reliably put into practice.

However, the trust leaders understood their duty to collaborate and work in partnership and recognised the importance of shared learning, so services work seamlessly for people. The trust focused on continuous learning, innovation and improvement across the organisation and local system. Leaders were aware of the trust’s impact on environmental sustainability. They were able to provide examples of where the trust had made changes to reduce the trust’s carbon footprint.

This is the first assessment of the trust’s overall leadership, under our single assessment framework. The trust’s leadership has been rated requires improvement

Requires improvement: This meant the trust management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

An action plan will be requested upon publication of the final report.

People's experience of this service

In the CQC Adult Inpatient Survey the trust was not listed as an overall trust outlier. There were 4 questions: information while waiting to be admitted, noise from other patients, not prevented from sleeping, help to wash and keep clean, where this trust scored worse than expected.

The trust had consistently been lower (better) than the national median and regional median for the percentage of beds occupied with patients clinically ready for discharge. Although the trust appeared to have been experiencing further pressures in achieving timely discharge in recent months with increasing numbers, only slightly below national.