A hospital trust has been branded inadequate by government inspectors.

A report published by the Care Quality Commission (CQC) today has given East Sussex Healthcare NHS Trust the lowest rating available.

Inspectors visited the trust last September and made a return visit this week before releasing the report this morning.

The trust runs Eastbourne District General Hospital and the Conquest Hospital in St Leonards and also provides community services across East Sussex.

The inspection is the latest in a new, tougher, level of checks carried out by the CQC at NHS trusts around the country.

It focuses on a range of services, including accident and emergency, medical care, surgery, intensive care, maternity, paediatrics, end of life care and outpatients.

The trust assessed on safety, effectiveness, caring, responsiveness and leadership.

It was branded inadequate for safety and whether it was well-led and found to require improvement on its responsiveness and effectiveness.

It was found to be good when it came to caring for patients.

Inspectors said they saw a number of issues that led to a rating for safety at the trust of inadequate.

They saw low staffing levels in surgery, maternity and pharmacy specifically.

Intensive and critical care was judged as ‘good’, but surgery and outpatients was ‘inadequate’.

In some areas, incident reporting, the feedback from incidents and the learning by both the organisation and individual staff was not as good as it should have been.

The  report said: “We were concerned about medicines management, particularly in surgery and in outpatients. Pharmacy services across the trust were also of concern.

“Patients’ records were not securely stored in outpatients. Medical records were unavailable and in poor state of repair. Clinicians had difficulty locating information upon which to base a decision.

“We observed staff, in the main, following good hygiene and hand washing practices. However we saw some areas where we were concerned by lack of compliance with good hand hygiene and trust policy, as well as staff who appeared to lack basic understanding of the policy.

“In many areas the hospital was clean and tidy; however we had concern over the cleanliness in some areas of maternity services.”

Inspectors said key findings included:

*The trust board recognises that staff engagement is an area of concern. Despite this we found a disconnect between the trust board and its staff.

*We saw a culture where staff were afraid to speak out or to share their concerns openly.

*We found that management of outpatients’ reconfiguration has led to service deterioration and a failure to respond to the needs of people using the service.

*We saw that waiting times in outpatients were excessive and did not meet government targets.

Areas of outstanding practice included the introduction of a handheld electronic system for recording patients’ observations and nurse-led discharge.

However, there were also areas of poor practice where the trust needs to make improvements.

The CQC recommends the trust must:

“ Rebuild the relationship with its staff grounded in openness, developing a culture of the organisation with regard to people feeling able to speak out.

“Undertake a root and branch review across the organisation to address the perceptions of a bullying culture.

“Improve relationships with stakeholders and the population it serves; specifically relating to their concerns about service configuration.

“Review staffing levels to ensure that they are sufficient for service provision.

Trust chief executive Darren Grayson said: "The reports reflect the journey we are on as an organisation and the immense changes we have made over recent years. 

"Despite change being tough for us all, this has already resulted in significant improvements to the way we care for patients, and ultimately more successful treatment of their illnesses and conditions.  

“I have always been honest about the fact that it isn’t an overnight job to change the culture of a large complex organisation such as ours and that there is always more that we can and want to do.

"I am determined that we can and will work together as an organisation to make improvements for patients and staff.”

In most cases, a rating of inadequate would lead to the Chief Inspector of Hospitals recommending that the trust be put in special measures.

However early indications from this week’s inspection, which focused on those services that were judged in September to cause the greatest concern – maternity, surgery and outpatients – are that improvements have been made.

As a result, any decision on special measures will be deferred until he has considered in full the findings of the latest inspection.