Agenda item - Brighton & Sussex University Hospitals Trust (BSUH): Care Quality Commission Inspection Report

Report of the Executive Lead, Strategy, Governance & Law on the recent Care Quality Commission (CQC) inspection of Brighton & Sussex University Hospitals Trust (BSUH) (copy attached)

38.1    The report was presented by Dr George Findlay, BSUH Medical Director. Dr Findlay told members that the recent CQC inspection report had seen the Trust’s ratings improve in every area, with BSUH now rated good overall and outstanding for the caring domain. The Trust is now out of both quality and financial Special Measures. Most of the credit for this rapid turnaround should go to staff across BSUH.

38.2    Challenges remain however. BSUH needs to improve the responsiveness of its services. The Trust has also been rated as requires improvement for its use of resources; BSUH still has a significant annual deficit and struggles to meet national waiting times targets, but the CQC has recognised that the position has improved and that there is a positive trajectory.

38.3    Members congratulated the Trust and its staff on BSUH’s improvement.

38.4    In response to a question from Cllr Marsh on the Royal Alex, Dr Findlay told the committee that the CQC had not included children’s care in its most recent inspection. Services at the Royal Alex had been found good or outstanding in the 2016 inspection report.

38.5    In answer to a query from Mr Vincent about end of life care, Dr Findlay told members that end of life services did not form part of the recent inspection. However, there has been significant investment in end of life since 2016, providing more specialist nurse and consultant post and a better general understanding of end of life care across the Trust.

38.6    In response to a question from Cllr Greenbaum on how further improvements would be resourced, Dr Findlay agreed that there was limited prospect of additional funding. However, the Trust spends more than £500 million per year and can fund improvement by identifying and eliminating waste within this spend. BSUH’s £30 million in-year savings programme is, in part, intended to identify savings in order to facilitate this type of investment.

38.7    In answer to a question from Cllr Janio on what the Trust does internally to drive improvement, Dr Findlay explained that the Patient First improvement programme that has proved highly effective in West Sussex hospitals had been introduced to BSUH. This uses data to drive improvement and forms a core component of management systems.

38.8    In response to a question from Cllr Janio on how the Trust hoped to access additional NHS funding (e.g. the £20.5 billion announced for the NHS in 2018), Dr Findlay informed the committee that partners are working together across the health economy to attract additional investment. A key part of this is being able to demonstrate that there is effective control over current budgets. To this end the Trust has agreed an aligned incentive contract with the CCG and is developing a medium term financial strategy with the active involvement of NHS England, NHS Improvement and the Treasury.

38.9    In response to a question from Ms McCabe on Western Sussex leadership at BSUH, Dr Findlay told the committee that the move had been successful because there had been a focus on leadership across BSUH, not just at executive level; a focus on internal governance; and a focus on culture change. The current contract with Western expires in April 2020 and negotiations with NHS Improvement about future arrangements are ongoing.

38.10  RESOLVED – that the report be noted.