THE Trust that runs Basildon and Thurrock Hospital and other medical care across south Essex has been strongly criticised in its latest Care Quality Commission report.

Inspectors have rated Mid and South Essex NHS Foundation Trust as 'requiring improvement', following an inspection undertaken between August and October.

Inspectors visited diagnostic imaging at Southend University Hospital as well as maternity services at Basildon University Hospital, Broomfield Hospital and Southend University Hospital.

The inspection was undertaken to assess concerns about the safety and quality of the services.

CQC also inspected trust's leadership arrangements, due to the link between leadership and the quality of care people receive.

In addition to rating the trust requires improvement overall, CQC rated it requires improvement for being safe, responsive to people's needs and well-led. CQC rated it good for being effective and caring.

Zoe Robinson, CQC head of hospital inspection, said:  "Although we found instances of good practice, despite the pressure NHS services and the wider healthcare sector face, there are improvements Mid and South Essex NHS Foundation Trust must make.

"These include ensuring care is not undermined in its maternity services by staffing shortages. While this is a national problem affecting many hospitals, leaders must develop ways of minimising the risk to patients this causes.

"The trust must also ensure its staff complete all relevant training to support them to meet patient need, and that it engages with patients and families in line with its legal obligations when something has gone wrong in a patient's care.

"However, staff collaborated well in the interests of patients.

"We also found the trust worked well with other local healthcare providers to support patients, and it captured people's feedback to help it improve.

"Following the inspection, we reported out findings to the trust's leaders – so they know where they have work to do. We continue to monitor the trust to ensure people receive safe and effective care and treatment." 

The inspection found:

• In addition to rating the trust requires improvement overall following the inspection, CQC rated its three major hospitals – Basildon University Hospital, Broomfield Hospital and Southend University Hospital – requires improvement.
• The following core services were inspected. Each was rated requires improvement:

- Maternity at Southend University Hospital

- Maternity at Basildon University Hospital

- Maternity at Broomfield Hospital

- Diagnostic imaging at Southend University Hospital.

• Across the trust, inspectors found not all staff had completed mandatory training.
• Maternity services did not have enough staff with the right qualifications, skills, training and experience to keep women safe from avoidable harm, and to consistently provide the right care and treatment.
• The trust did not always share learning from incidents, or ensure mitigating actions were appropriately embedded.
• The duty of candour, a legal obligation requiring healthcare providers to be open and honest with patients and their families after something has gone wrong in their care, was not discharged as soon as reasonably practicable after a notifiable safety incident had occurred.
• Nurses and midwives did not always receive an appraisal in line with the trust's target.
• Women using the trust's maternity services were not always triaged within target times, neither could they always access the service when they needed it. This meant they did not receive the right care promptly or within national target times.

However:

• Staff provided care and treatment based on national guidance and evidence-based practice.
• Doctors, nurses and other healthcare professionals in maternity collaborated to benefit women and babies.
• People could easily give feedback and raise concerns, and complaints were taken seriously.
• Leaders operated effective governance processes throughout the trust and with partner organisations.

The inspection report is published on CQC's website.  

A response from the Trust's acting chief executive Hannah Coffey concentrated on the positives. She said: "There are some very positive findings in this report, and I'd like to thank our staff for continuing to provide such high quality care to our patients.

"It is absolutely right that the inspectors have highlighted some of the challenges we face and recognise the pressures that the NHS is under. We know there is work to be done and this report is helpful in assuring us that we are focusing our efforts in the right areas."

The inspectors highlighted that there were issues with staffing across maternity services nationally, and told the Trust it must take action to improve the situation.

Ms Coffey said: "We have made great strides in improving maternity staffing since the CQC visited us. I am delighted that all of the student midwives who trained with us have applied to work here, so we have 52 enthusiastic newly-qualified midwives in our departments.

"We have also recruited nine international midwives, with plans in place to bring in another eight.

"Recruitment in the NHS will continue to be an issue, and we will need to maintain our focus, but we are seeing a sustained improvement which ensures we can always provide women with one-to-one care in labour.

"While appraisal and training rates have improved since the inspection, we know that there is more to be done to ensure that we have really robust processes in place. We are an improving organisation with a dedicated workforce committed to providing the very best care."