An NHS boss has set out how his trust has improved after a damning report from the health watchdog revealed problems with leadership, bullying and staff shortages were putting patients at risk of harm.

The Care Quality Commission (CQC) has downgraded the overall rating of University Hospitals Sussex NHS Foundation Trust from outstanding to requires improvement after an inspection between October and December showed a decline in the care being provided to people across several key areas.

UHSussex chief executive Dr George Findlay, who has been in post just under a year, said the trust needs to improve as it faces challenges around staffing, a fast-growing need for hospital services and recovery from the Covid-19 pandemic.

He also said positive changes have taken place both before and since the latest CQC inspection in October 2022, including “huge” investment in better facilities, a new leadership structure, recruitment at all levels and a big effort to encourage a more open culture.

Improvements made during Dr Findlay’s first year as chief executive include:  

• A new leadership development programme to support leaders across the trust

• A new clinical model to give strong leadership to clinical divisions and individual hospital sites

• Trust-wide focus on making it easier for people to speak up and raise concerns, including stronger support for the Freedom To Speak Up service. Results from the anonymous monthly “Pulse” staff survey show more people now feel confident that the trust would act upon concerns that were raised, up from 49 per cent in September 2022 to 58 per cent in March 2023, closing in on the best-performing trusts nationally.

• £120 million invested across all hospital sites (above and beyond the £500 million Louisa Martindale Building and planned £48 million redevelopment of A&E in Brighton)

• Weekly, structured sessions with frontline staff involving the whole executive team and one or more executive team member spending time with frontline teams every day

•  Strong progress in patient care including:

•  Significant reduction in the number of people facing the longest waits for treatment – now only just over 250 people

• Ambulance delays of an hour or more down to 3.2 per cent, from nine per cent at the end of 2022

•  Waits of more than six weeks for diagnostics down by almost a third since late 2022

• Strengthening performance for cancer waiting times, both for diagnosis and treatment.

The CQC team visiting in 2022 also concluded:  

New strategies would “improve quality for patients and staff”.   

“Majority of leaders had the experience, capacity and capability to lead effectively.   

“Most patients praised the care, treatment and support they received.   

“The executive team had an appropriate range of skills, knowledge and experience.   

“The new operating model appeared to provide clear structures and evidenced multi-disciplinary leadership both across hospital sites and divisions."   

Dr Findlay said: “When I took up this role just under a year ago I commissioned an external review to give me a clear picture of where we stood as a newly formed trust – our strengths and our weaknesses. This review and our improvement plans were shared with the CQC at the time of our 'well-led' inspection.

“Everything the CQC is saying now chimes with what we already knew and had committed to addressing right from the start. 

“I’m extremely proud of the huge strides that colleagues have made but we all recognise how much work still lies ahead. The seven months since this inspection have seen rapid progress – now we need to push on again.”