The Mid and South Essex NHS Foundation Trust has been told it must improve by the Care Quality Commission (CQC), following inspections at its maternity, surgical, medical, urgent and emergency services.

The CQC announced that the trust has been rated as "requires improvement" overall in a report published today (Wednesday, 1 December).

The trust was rated as "good" for being effective and caring but as "requires improvement" for being safe, responsive and well-led, which led to the overall rating of "requires improvement".

It follows an unannounced inspection carried out by CQC over July, August and September at Broomfield Hospital, Southend University Hospital and Basildon University Hospital - the trust's three main sites - to investigate concerns about the quality of care people were receiving.

The report said shifts regularly had below planned numbers of nursing and medical staff, not all staff had received mandatory training, records were not always accurate or kept securely and "patients were not always protected from harm".

The report also said the CQC had received a "high number" of whistleblowers across the trust, with 43 whistleblowing enquiries between August 2020 and August 2021.

The majority of whistleblowing information was from maternity services.

However, the report found that staff remained "unwavering" in their focus on the needs of patients - despite the pressures faced by the trust as a result of the pandemic.

It said staff treated patients with "passion and kindness", and worked together as a team to benefit those under their care.

At Broomfield Hospital, inspectors found:

• The maternity department was often understaffed which impacted on staff morale and workload.
• Managers investigated incidents and shared lessons learned with the whole team and wider service.
• Surgery staff identified and quickly acted upon patients at risk of deterioration. However, safety checklists and assessments were inconsistently completed.

At Southend University Hospital, inspectors found:

• Staff in the emergency department did not feel respected, supported or valued. The service did not have an open culture where staff could raise concerns without fear.
• The surgery service did not always have enough medical staff with the right qualifications, skills and experience.
• There was no robust process in place for prioritising women in the maternity service once they had been triaged.

At Basildon University Hospital, inspectors found:

• The maternity service managed patient safety incidents well. Staff recognised and reported incidents and near misses.
• Leaders in the maternity service understood and managed the priorities and issues the service faced. Local leaders were visible, approachable and supported staff to develop their skills and take on more senior roles.
• Understaffing in surgery was often an issue but managers regularly reviewed and adjusted staffing levels and skill mix to keep patients safe.

Inspectors also found the following "outstanding" practice at Basildon University Hospital:

• The same day emergency care (SDEC) service had developed an admission avoidance pathway for Covid-19 patients to allow them to be monitored safely at home. This pathway could be adapted for other respiratory conditions.

The trust was formed on 1 April 2020 following the acquisition of Mid Essex Hospitals Services NHS Trust and Basildon and Thurrock University Hospital Trust by Southend University Hospital NHS Foundation Trust.

Philippa Styles, head of hospital inspection at CQC, said: "Our inspection of Mid and South Essex NHS Foundation Trust found a mixed picture with areas where positive improvements had been made, but also areas where concerns were found.

"Following the trust's formation in 2020, leaders should now be able to work together effectively to ensure care is consistent across all services.

"I recognise the enormous pressure NHS services are under across the country and that usual expectations cannot always be maintained, especially in the urgent and emergency department, but it is important they do all they can to mitigate risks to patient safety while facing these pressures.

"We did find however, that women and babies were having a better experience at Basildon University Hospital's maternity department due to improvements.

"There has been historic issues and enforcement action in this department over a number of years, so it is very encouraging they are now making progress to ensure women have a positive birth experience.

"There was a decline in the quality of care being provided at Southend University Hospital's maternity service. The service was continually short-staffed which affected midwives' ability to work effectively.

"Leaders must ensure these issues are addressed so staff feel supported to do their jobs safely.

"Despite this challenge, staff and managers worked well with local organisations to ensure women received timely and appropriate care.

"The pandemic has been extremely challenging for urgent and emergency department staff, with many having low morale and being fearful to raise concerns. The leadership team was aware of this issue and had commissioned an external review of culture within the department.

"We continue to monitor the trust closely to focus its attention on the areas where it must improve, and to help it sustain areas where progress has already been made. We will return to check on their progress."

You can read the report on the Mid and South Essex NHS Foundation Trust here.