- CQC found “huge improvements”
- Culture change singled out for praise
- Chief executive insists improvement is not about “heroic leadership”
There is no “silver bullet” to improve failing trusts, the chief executive of the latest NHS trust to jump from an “inadequate” to “good” Care Quality Commission rating has said.
Instead, Dame Marianne Griffiths, chief executive of Brighton and Sussex University Hospitals Trust, said addressing governance, culture and leadership can bring rewards.
She also paid tribute to the trust’s “magnificent” staff, who she said had had a tough few years before today’s CQC report. As well as its improved rating, the trust has also been taken out of quality special measures.
Among the reasons behind the trust’s improved rating, Dame Marianne highlighted:
- The impact of more consistent and stable leadership. Before she was appointed 20 months ago, BSUH had had four chief executives in around four years. Staff now felt more confident and there was optimism for the future, she said, adding: “It is all about how the staff feel about the organisation.”
- Leadership by a team rather than a “heroic” individual. When she joined the trust, senior staff at Western Sussex Hospitals Foundation Trust – where she remains chief executive – also came to help, working with leaders within BSUH.
- The use of the Patient First methodology as a tool for organisational development and continuous improvement. This empowers staff to make improvements themselves.
- Support from regulators to give a trust which had multiple financial and quality issues “space” to improve together with good relationships with other organisations in the local health economy. The trust was moved out of financial special measures in 2018.
- Revised governance arrangements, which staff were engaged with, and creating a “shared ambition” for the trust.
The CQC report said staff talked of a “paradigm shift” in the trust’s culture, which felt “inclusive, empowering and positive”. Quality was a “golden thread” throughout the trust, which had made “huge improvements” and was rated “outstanding” for caring.
Caroline Dinenage, care minister, said: “It is testament to the hardworking staff at Brighton and Sussex that the trust has shown such improvement over the last two years, and it is with great pleasure that I congratulate them in coming out of quality special measures today”.
The CQC rated BSUH “inadequate” after a 2016 inspection found numerous areas of concern, including low staffing, a disconnect between ward and board, risks for patients being “cohorted” in accident and emergency, and fire safety issues.
In April 2017, Dame Marianne took on the leadership of the trust under a three year deal, which has also seen Western Sussex and BSUH share a chair.
“At the end of it [the three year arrangement] there is a decision to be made about what happens and I hope it is a positive one about extending it,” she said.
But she stressed the trust still had challenges, including around capacity and finances. It is currently undergoing a £500m redevelopment of its main site, the Royal Sussex County Hospital – the 3Ts project – which will alleviate some of the capacity issues.
“We have made this level of improvement. If we can embed and keep staff so engaged, then we can meet the challenges,” she said.
CQC report and interview with HSJ