Colchester Hospital University NHS Foundation Trust

Colchester Hospital University NHS Foundation Trust operates from two main sites - Colchester General Hospital and Essex County Hospital. The trust provides healthcare services to around 370,000 people from Colchester and the surrounding area of north east Essex. The trust employs around 4,168 staff.

In addition, the trust provides radiotherapy and oncology services to a wider population of about 670,000 people across north and mid-Essex.

The trust owns and manages Colchester General Hospital, which opened in 1984, and Essex County Hospital, which was established in 1820. In addition, the trust also provides some services, such as outpatient and maternity services, at the community hospitals in Clacton and Harwich – run by Anglian Community Enterprise (ACE) – and Halstead Hospital, which is run by Central Essex Community Services (CECS). The trust also runs a limited range of community services.

For the purposes of the comprehensive inspection, we focused on the Colchester General Hospital and Essex County Hospital, given the majority of services are delivered from these sites.

The Care Quality Commission (CQC) carried out a comprehensive inspection between the 6 and 8 May 2014. The inspection was undertaken as part of the review undertaken by Sir Bruce Keogh. The Keogh Mortality Review looked in detail at those trusts whose Standardised Hospital Mortality Indicator (SHMI) suggested possible concerns around quality of care. The CQC was asked to inspect all of the Keogh trusts in order to make a judgment on the quality of care being provided by these organisations.

The comprehensive inspection involved an on-site review of:

• Accident and emergency (A&E)

• Medical care

• Surgery

• Critical care

The on-site element of the inspection involved a team of experts by experience (service users), clinical associates (experienced healthcare professionals) and CQC inspectors. The team is divided into subteams, each of which looked at one the service lines described above. The subteams were led by an experienced inspector, supported by clinical experts.

Prior to the CQC on-site inspection, the CQC considered a range of quality indicators captured through our intelligent monitoring processes. In addition, we sought the views of a range partners and stakeholders. A key element of this is the public listening events and focus groups with healthcare professionals.

We returned on 12 and27 November and 23 December 2014 to follow up on concerns raised to inspect the A&E department and the Emergency Admissions Unit.

The inspection team make an evidenced judgment on five domains to ascertain if services are:

• Safe

• Effective

• Caring

• Responsive 

• Well-led.

The comprehensive inspections result in a trust being assigned a rating of ‘outstanding’, ‘good’, ‘requires Improvement’ or ‘inadequate’. Each section of the service receives an individual rating, which, in turn, informs an overall trust rating. The inspection found that overall the trust had a rating of requires improvement following the comprehensive inspection but was rated as overall inadequate following our responsive inspection in November and December 2014.