The inspection was triggered by concerns CQC received about risk within the trust's front-line services, which prompted assessments of urgent and emergency care and maternity services ahead of the well-led review.
Amanda Williams, CQC deputy director of hospitals, secondary and specialist care for the South East, said: ‘When we inspected University Hospitals Sussex NHS Foundation Trust in July, we found a trust that had made progress since our previous visit, but one that still has significant work to do, particularly in leadership, culture and risk management.'
Workforce culture
Inspectors found the leadership team had strengthened its freedom to speak up arrangements since the last inspection by appointing a dedicated guardian who visited sites at least twice a week. Locally, it encouraged a culture where 71% of staff felt comfortable raising concerns with their line manager.
However, the CQC found the trust had not acted with sufficient pace or consistency to address discrimination and inequity. Staff from minority ethnic backgrounds continued to report poorer experiences across all indicators, disability-related discrimination had worsened year on year.
Partnership working
The trust worked effectively with partner organisations, including local authorities, mental health services, and community and patient groups, including the Maternity and Neonatal Voices Partnership, the CQC said.
However, information sharing with system partners was limited, accountability for improvement was not always fully owned and engagement with trade union representatives had not been routinely embedded in strategic decision-making.
Trust response
Dr Andy Heeps, chief executive, University Hospitals Sussex NHS Foundation Trust said welcomed the improved leadership rating as a ‘step forward' but acknowledged ‘there is much more to do'.
‘The report is clear that we need to strengthen leadership, culture, risk management and learning from incidents,' Dr Heeps said.
‘It is particularly concerning that some colleagues reported not feeling safe to raise concerns – we need to ensure people feel confident and encouraged to speak up, because that helps to drive improvements in care quality and safety.
‘Since the inspection last summer, we have strengthened our executive and board, launched our new strategy setting our direction until 2030, and introduced a new operating model with clearer accountability for services and patient care.
‘Next week we will begin a new drive to set clearer expectations for how we all work with each other, from the board to every ward and service. Our staff do extraordinary work for patients every day, and our responsibility is to give them the support, culture and confidence they need to provide consistently excellent care.'
