Trust’s Leadership Inadequate

THE Care Quality Commission (CQC) has rated leadership at Mid and South Essex NHS Foundation Trust, including Southend Hospital, as inadequate following an inspection in May.
Mid and South Essex NHS Foundation trust was formed on 1 April 2020 following the merger of Basildon and Thurrock, Mid Essex and Southend NHS trusts. Acute hospital care means treatment and support in hospital for short-term or serious health problems that need urgent or specialist attention.
The trust is the only provider of this type of hospital care within the Mid and South Essex Integrated Care System. They cover a diverse population with areas of significant deprivation.
The trust has three main hospital sites, Southend, Broomfield and Basildon Hospitals and had a £1.5 billion turnover with 16,871 staff providing services to a population of 1.2 million people.
This inspection looked at how well-led the trust is and was carried out in response to ongoing concerns identified during recent inspections of the trust’s maternity, children and young people’s services and urgent and emergency care, where enforcement action was taken and a warning notice was issued.
CQC currently gives NHS trusts a single trust-level rating focusing on leadership and culture that replaces all other ratings at that level. CQC is consulting on this approach following recent feedback from those in the sector and learning from the reviews by Dr Penny Dash, Professor Sir Mike Richards and the Care Provider Alliance.
Hazel Roberts, CQC deputy director of operations in the East of England, said: “During our well-led inspection of Mid and South Essex NHS Foundation Trust, we found serious and systemic failures in leadership and organisational culture that were putting people at risk and leaving staff feeling unsupported and undervalued.
“Leaders were aware of many of the challenges they faced, but were unable to demonstrate how services would improve at the pace and scale required. Despite numerous improvement programmes, we found persistent quality and safety failures that led to enforcement action in maternity, children and young people, and urgent and emergency care services.
“Staff across all three hospital sites told us they felt disconnected from senior leaders, undervalued, and unable to raise concerns without fear. Many described a culture where poor behaviours went unchallenged, and where financial pressures were perceived to take priority over quality and safety.
“However, the trust recognises the issues and challenges it continues to face. It acknowledges that further work is needed to improve the areas we’ve highlighted and to reduce the number of serious, preventable safety incidents which shouldn’t have happened.
“Leaders have demonstrated an awareness of where improvements are required and have begun taking steps to address these.
“We have told leaders the areas where improvements are needed to ensure the trust is led successfully, and we will continue to monitor them, including through future inspections, to ensure the necessary improvements are made.”
Inspectors found:
The trust has struggled to complete mandatory reviews of deaths in a timely manner, with only 65% of reviews completed on time. These are critical for learning lessons and preventing future harm.
The new operating model introduced last November caused confusion around roles, responsibilities, and accountability, undermining effective leadership and governance.
Staff engagement and morale were among the lowest in the country. In the 2024 NHS Staff Survey, the trust received the worst score nationally among similar trusts for being compassionate and inclusive.
Staff didn’t feel safe raising concerns. Only 59.4% of staff said they would feel secure raising concerns about unsafe clinical practice, compared to 70% nationally. And only 40.5% felt confident the organisation would address their concerns, against a national average of 55.1%.
The trust was among the worst-performing nationally for ambulance handover delays and cancer waiting time standards, although some improvement had been seen at individual sites.
The trust had no formal leadership strategy or talent management programme, and appraisal compliance remained poor despite the introduction of a new system.
Picture: Southend Hospital.
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