Press Release: Two reports on the patient experience and physical environment at Brighton hospitals

Press Release 14/08/2019

Today we publish two reports:

  1. An annual review of our environmental audits at Brighton and Sussex University Hospitals NHS Trust (BSUH),
    showing continued improvement for patient experience and the physical environment.
  2. A historic review of Patient Led Assessments (PLACE) results for 2013-2018 for BSUH and Sussex Partnership Foundation Trust (SPFT),
    highlighting improvements, but also where further work is required.

Annual report of Healthwatch Environmental Audits at BSUH – main findings (April 2018 to March 2019)

Since December 2016, Healthwatch Brighton and Hove has worked in partnership with our local Trust to conduct monthly visits to the Brighton and Sussex University Hospital Trust (BSUH) estate which includes the Royal Sussex County Hospital (RSCH) and Royal Alexandra Children’s Hospital (RACH).  These monthly visits are called Environmental Care Audits (“audits”).  Today we have published the second Healthwatch annual report which summarises the key findings from the audits which were undertaken from April 2018 to March 2019. Our first annual report is available on the Healthwatch website.

Quoting from the report David Liley, Chief Officer, Healthwatch Brighton and Hove said:

“Healthwatch has been impressed by how quickly the Trust has acted on many of our recommendations and suggestions, and in a number of cases we were able to witness first-hand the tangible improvements that were made. Examples of this are the notable improvements made to the elderly people’s wards (Chichester, Bristol, Jowers and Valance) over just a seven-month period. We have provided this as a case-study on page 14 of our report as it demonstrates the benefits that our Healthwatch audits can bring; and it also demonstrates the excellent working relationship between our two organisations. Healthwatch applauds the Trust and staff for responding so positively to the feedback from Healthwatch and for taking such speedy action.”

Between April 2018 to March 2019:

  • Healthwatch volunteers undertook ten separate monthly audits across the BSUH estate.  This included wards and clinics at the Royal Sussex County Hospital.
  • Healthwatch provided BSUH with 220 recommendations or suggestions for how the environment of our local hospitals might be improved.
  • The Trust was able to implement 160 (74%) of our recommendations. Others were not practical or possible for various reasons.
  • Three of the ten audits we conducted were to areas of the Trust that Healthwatch had not visited before.  The remaining seven audits were revisits which involved our volunteers comparing current ward environments against historical data. During these audits Healthwatch observed tangible improvements across many wards.

A historic review of PLACE results 2013-2018 for BSUH and SPFT

Patient-led assessments of the Care Environment (PLACE) are arranged by the NHS not Healthwatch. However, Healthwatch is routinely approached by two of our local Trusts to help conduct these important assessments working alongside other volunteers and some NHS staff. The PLACE reviews are held annually and are managed nationally, and the findings are analysed by NHS Digital. PLACE provides a framework for assessing the quality of Trusts against six common standards:

  1. Cleanliness
  2. Food and hydration
  3. Privacy and dignity
  4. Condition and maintenance
  5. Meeting the needs of those living with dementia
  6. Meeting the need of those living with a disability

This is the first time that Healthwatch has undertaken an analysis of the PLACE results. This work has revealed the general upward trend in scores being achieved by both Trusts, but has also served as a useful tool to highlight those areas which require additional attention. Healthwatch has been able to raise its concerns directly with senior staff and has been reassured by the response of both Trusts.

David Liley, Chief Officer, Healthwatch Brighton and Hove, said:

“Taking a five year historic view tells us where we have been, not necessarily where we are going. From 2013 to 2018, our local Mental Health Trust, on two sites in Brighton and Hove, maintained consistently high PLACE scores.  They are to be commended for that. Our analysis reveals however that in 2018 additional attention was needed to address the declines in some standards at Rutland Gardens.

For BSUH, we know that for some of the five years from 2013-18 have proved to be challenging and that considerable improvements were needed. Many improvements have already taken place and more are in the pipeline – senior management at the Trust have driven forward these changes despite this being one of the busiest major hospitals in the UK, and with all the disruption of building and redevelopment work.

An important development over the last two years has been closer working with Healthwatch as an independent voice for patients and the public. Healthwatch reports are now an integral part of the BSUH quality monitoring system, from individual patients and wards up to the senior nurses and doctors and the Trust Board.”

Main findings for BSUH

 Between 2013 – 2017, BSUH improved its scores across a number of standards, particularly for ‘cleanliness’ and ‘maintenance, condition and appearance’ (see Annex C of our report for more detail).  In 2018, scores for some standards fell unexpectedly and the Trust has already moved swiftly to implement a range of measures to improve things, including the creation of the Food Improvement Group and publication of its dementia strategy. In January 2019 BSUH was deservedly taken out of special measures with the CQC rating the Trust as ‘Good’ overall.

In 2018, a number of the six sites which constitute the BSUH Trust achieved high PLACE scores notably for their ‘cleanliness’ and ‘condition, maintenance and appearance’ and their success is to be applauded:

  • The Sussex Orthopaedic Centre increased their scores across five standards
  • The Royal Alexandra Children’s Hospital (RACH) increased their scores across three standards
  • The RSCH and the Sussex Eye Hospital either maintained or slightly increased their scores across two standards.

Healthwatch shares the BSUH senior team’s disappointment in the overall PLACE scores achieved in 2018. We agree that these scores do not reflect all of the hard work that has gone in to improving the environments of all six sites.  In 2018, the PLACE scores achieved across the six sites varied considerably, and the lower than expected scores achieved by the Princess Royal hospital has unfortunately affected the overall BSUH averages.  Once again, the Trust has already started work to tackle any shortfalls and we look forward to seeing improved scores following the completion of PLACE 2019 which we understand will occur later this year.

Main findings for SPFT

Between 2013 – 2018 the Trust improved its scores across all six standards.  SPFT’s overall 2018 PLACE scores are to be applauded and their success is mirrored by the findings of their latest CQC report.  The 2018 PLACE results reflect the outcomes of twenty individual site assessments, with the majority of these posting very good results. Healthwatch supported the Trust to complete two site assessments at Mill View and Rutland Gardens.

  • Healthwatch would like to acknowledge the improvements achieved by Mill View Hospital. Their scores increased in 2018 for the areas of ‘condition, appearance and maintenance’, ‘food and hydration’, dementia’ and ‘disability’ standards.
  • Although SPFT’s overall score for the ‘food and hydration’ standard remained very good, we note that there has been a small year-on-year reduction since 2015. In addition, the current score is the lowest ever achieved by SPFT.
  • Healthwatch is concerned by some of the poor results recorded by Rutland Gardens, which is one of two sites that we helped to assess. The scores for the ‘privacy, dignity and well-being’ and ‘disability’ standards both dropped by over 30% when compared to 2017.   These were also the lowest scores out of the twenty SPFT sites visited for PLACE 2018. These are significant and worrying decreases.  Healthwatch has already raised these with SPFT who have indicated that they are investigating the reasons for these falls.

Read the Reports

For further information or interviews please contact:

David Liley, Chief Officer Healthwatch Brighton and Hove

07931 755 343