Care Quality Commission report: Royal Sussex County Hospital - maternity and urgent & emergency care

Maternity

The latest rating for this service is 'Requires improvement'.

The maternity service at Royal Sussex County Hospital (RSCH) forms part of University Hospitals Sussex NHS Foundation Trust maternity services, which also includes Worthing Hospital, St Richards Hospital and Princess Royal Hospital. CQC assessed the maternity services to determine if they had made improvement since their last comprehensive inspection in 2021, when the service at RSCH was rated 'inadequate'. They had also completed a focused inspection in 2022 which was not rated.

CQC carried out an unannounced assessment of the maternity services at Royal Sussex County Hospital. This assessment was in response to information of concern they received associated with risk within the service.

Following the focused inspection in 2021, they saw improvements, but the service was in breach of regulation 12: safe care and treatment in relation to triage processes and checks on lifesaving equipment. The service had made improvements and was no longer in breach of regulations in relation to this regulation.

Although they saw improvements during this assessment (2025), the service remained in breach of regulations. The overall rating for the Maternity service has improved from 'inadequate' to 'requires improvement' overall.

At this assessment, CQC inspected this service using their single assessment framework and looked at all the key questions and 33 quality statements.

Royal Sussex County Hospital provides obstetric and midwifery services along with community midwifery care. The service includes pre-conceptual care, early pregnancy care, antenatal, intrapartum and postnatal care. The maternity unit includes an early pregnancy unit, obstetric consultant-led delivery suite, maternity assessment centre (triage), and wards for antenatal and postnatal care.

Approximately 9,000 babies are born within the service each year; RSCH accounts for 2,444 births reported from January 2024 to January 2025.

CQC visited the following areas as part of the assessment:

• Postnatal and antenatal wards
• Triage and assessment areas
• The early pregnancy unit
• The theatre, recovery area, and labour suite
• CQC also looked at bereavement facilities, and outpatient areas, including antenatal consulting areas and pregnancy scanning.

CQC spoke with 12 patients and two relatives/carers. They reviewed eight patient records. They also spoke with more than 35 staff which included: 

• Consultants
• Resident doctors
• Midwives, including specialist and community-based midwives
• Matrons
• Senior leaders
• Maternity support workers
• Administration staff
• Pharmacists
• Housekeeping staff
• Student midwives.

CQC found five breaches in regulations. The service was in breach of legal regulation(s) in relation to people’s safe care and treatment and governance.

The breaches related to appropriate management of risks including induction of labour and caesarean section delays, medicines management, safeguarding, and the premises at Sussex House. They also found breaches in relation to the governance of the service. The breach was in relation to risks not being addressed in a timely manner, staff access to patient information, assurance through auditing systems, setting of targets, and benchmarking processes. Staff could not easily access information in one place on mothers or babies to ensure risks are appropriately managed.

CQC has asked the provider for an action plan in response to the concerns found at this assessment.

NB. CQC refers to women in this report, but recognise that some transgender men, non-binary women, and women with variations in sex characteristics (VSC) or who are intersex may also use services and experience some of the same issues.

Urgent and emergency services

The latest rating for this service is 'Requires improvement'.

CQC carried out an unannounced assessment of the Urgent and Emergency Services at the Royal Sussex County Hospital, Brighton. This assessment was in response to information of concern they received associated with risk within the service.

CQC last assessed Urgent and Emergency Services in 2022 and rated the service as 'requires improvement'.

The service was previously in breach of regulation 12: Safe Care and Treatment, and regulation 10: Dignity and respect. Improvements were not found at this assessment, and the service remained in breach of regulations. 

They assessed this service using their single assessment framework and looked at all the key questions and 24 quality statements. CQC visited the major assessment and treatment area, minor assessment and treatment area, mental health assessment area, ambulance arrival area, resuscitation area, patient assessment and triage, ambulatory emergency department and the urgent treatment centre (UTC). They spoke with 40 patients and relatives/carers, and reviewed 20 patient records.

They also spoke with more than 60 staff which included: 

• Leaders of all levels
• Nurses
• Doctors
• Allied health professionals
• Administrators
• Paramedics
• Estates staff
• Site coordinators
• Practice educators
• Healthcare assistants
• GPs
• Emergency Nurse Practitioners
• Flow coordinators
• Pharmacy technicians.

CQC found two breaches in regulation in relation to safe care and treatment and privacy and dignity. People waited within the department for long periods of time, the department was overcrowded, and staff could not always track where each patient was located. Staff could not always get emergency equipment to patients. Fire exits were blocked; no nominated fire officer, and staff did not understand the evacuation process. It was not possible to clean the floor of the temporary escalation area as there were too many patient trolleys.

People experienced long delays before being admitted to a ward. Seriously unwell patients could not be monitored safely in high dependency areas of the department due to overcrowding. People’s privacy and dignity could not be maintained, and staff could not regularly check the patients’ comfort, skin integrity, or ensure patients had enough to eat and drink.

The trust operated local clinical governance processes under the urgent care and medicine triumvirate. A clinical policy group managed monthly meeting agendas. The Acute Floor Directorate oversaw clinical governance and submitted reports to the Divisional Governance Group. In turn, the Divisional Governance Group reported to the Quality Governance Steering Group (QGSG), which the Chief Nurse and Chief Medical Officer jointly chaired.

Following the assessment, CQC issued a letter of intent about possible urgent enforcement action under section 31 of the Health and Social Care Act 2008, and asked the provider for an action plan in response to the serious concerns found at this assessment. The CQC met weekly with the senior leadership team to monitor compliance with the action plan until June 2025.