Updated 6 May 2026
University Hospitals Sussex NHS Foundation Trust provides clinical services to people in Brighton and Hove, parts of East Sussex and West Sussex.
The trust came into existence because of an acquisition by Western Sussex Hospitals NHS Foundation Trust of Brighton and Sussex University Hospitals NHS Trust on 1 April 2021. The trust is now one of the largest organisations in the NHS employing nearly 20,000 staff and serving a population of around 1.8 million people in Sussex.
The trust runs 7 hospitals across Brighton and Hove, West and Mid Sussex and parts of East Sussex.
The trust provides 24-hour accident and emergency, and maternity services on 4 hospital sites, with Royal Sussex County Hospital in Brighton being a centre for major trauma and tertiary specialist services. The trust also provides specialist services for patients from across the wider South-East region.
Date of assessment: 15 to 17 July 2025. We carried out an announced trust level assessment at University Hospitals Sussex NHS Foundation Trust. We last inspected how well-led the trust was in 2023, when we rated them inadequate. At this assessment we rated them as requires improvement.
We assessed the trust using our single assessment framework. We assessed all 8 of the quality statements in the well-led key question using our current framework. We reviewed evidence for quality statements in line with published evidence categories.
The well-led review followed assessments of the trust’s front-line services (assessment service groups - ASGs). The locations and ASGs we assessed included urgent and emergency care, and maternity services at Royal Sussex County Hospital and maternity services at Worthing Hospital. We undertook these assessments to ensure we had a thorough understanding of services provided by the trust ahead of our well-led review. 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.
The trust was previously in breach of Regulation 12: Safe care and treatment and Regulation 17: Good governance. Although we found improvements at this assessment, the trust remained in breach of Regulations 12 and 17.
We found breaches in regulation in relation to safe care and treatment and good governance, oversight and management of risk, lack of oversight of action plans following incidents and poor culture. Work was still needed to consider if the Workforce Race Equality Standard and NHS staff survey to ensure staff from ethnic minority groups were not disproportionately disadvantaged by working in the organisation. Governance arrangements lacked clarity and were not always effective at all levels, which needed streamlining and strengthening to be more effective. The systems and processes for managing risk were not always effective.
Not all staff felt there was a culture based on transparency, equity, equality, human rights, diversity and inclusion. Not all staff felt respected, supported and valued. Leaders understood the priorities and challenges the trust faced but had not always taken appropriate action to resolve them. Some executives were visible and approachable in the trust. Most staff reported a disconnect between the ‘’board and the floor’ (front-line services). The trust had a new strategy, which had not been shared with staff at the time of our assessment.
The trust did not always understand their duty to collaborate and work in partnership, so that services work seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.
However, 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.
We have asked the provider for an action plan in response to the concerns found at this assessment.