Hospital staff working in a 'culture of fear'

Hospital inspectors have warned of a culture of fear at a Sussex hospital trust that could potentially affect patient care.

The Care Quality Commission (CQC) inspected hospitals run by University Hospitals Sussex NHS Trust (UHS) in July 2025.

The CQC said the trust remained in breach of two regulations relating to safe care and treatment and its overall management, but inspectors upgraded the rating for leadership from inadequate to requires improvement.

Dr Andy Heeps, UHS chief executive officer, said the report made it clear "we need to strengthen leadership, culture, risk management and learning from incidents".

The trust provides hospital services for people across Sussex, including in Brighton, Worthing, Haywards Heath and Chichester

Amanda Williams, CQC deputy director of hospitals in the South East, said her team found the trust had made progress since their previous visit, but still had significant work to do.

"Many staff felt their voices weren't being heard, with some describing a culture of fear where concerns were overlooked or dismissed.

"When staff do not feel safe to speak up, issues can remain unresolved, potentially affecting the quality of care."

She added that in urgent and emergency care and maternity services, risks that should have been identified and addressed through internal processes were not always acted upon.

She said: "Although maternity staff understood reporting procedures, incidents weren't consistently reported, with some staff citing a lack of visible action as a reason for disengagement.

"In urgent and emergency care, risks such as overcrowding, unsuitable environments, staffing pressures, infection control, and the use of escalation areas were recorded, but there was limited executive-level response to their severity.

"People waiting for treatment in emergency departments experienced long stays in environments that were not always appropriate, particularly for those with mental health needs.

"However, we also saw strong commitment from staff, and around 90% of people reported a positive overall experience."

Heeps welcomed the recognition that the trust had made progress but said it was particularly concerning that some colleagues reported not feeling safe to raise concerns.

"We need to ensure people feel confident and encouraged to speak up, because that helps to drive improvements in care quality and safety," he said.

"Since the inspection last summer, we have strengthened our executive and Board, launched our new strategy setting our direction until 2030, and introduced a new operating model with clearer accountability for services and patient care.

"Our staff do extraordinary work for patients every day, and our responsibility is to give them the support, culture and confidence they need to provide consistently excellent care," he added.

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