The Care Quality Commission inspected the trust in November 2025, and found issues in how the trust is managed, as well as instances of bullying and harassment among staff.
Leadership within the trust was previously rated as ‘outstanding’ by the CQC but has now been classed as ‘needs improvement.’
Amanda Williams, CQC deputy director of hospitals, secondary and specialist care for Surrey and Sussex described the staff as ‘hard working.’
However she said there was a ‘significant gap’ between the ambitions of leaders and the reality experienced by staff and patients.
Ms Williams said: “What concerned us most was how many staff told us they didn’t feel safe to speak up. Our inspectors heard that raising concerns through formal channels was difficult, that people feared reprisal and that concerns weren’t always resolved when they were raised.
“If staff don’t feel they can speak up, risks go unaddressed and that can have real consequences for the people in their care.”
Ms Williams went on to say that staff described feeling burnt out and undervalued.
Inspectors found that a larger proportion of staff no longer believed care of people was the top priority of the trust.
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Ms Williams also said the report found staff from ethnic minorities, who made up almost half the workforce, and those with disabilities had worse experiences than their colleagues, faced higher rates of bullying and harassment and had fewer opportunities to progress.
Ms Williams said: “That kind of disparity cannot be ignored.”
Inspectors also identified other issues within the trust, including not addressing inequalities affecting those in more deprived areas, such as longer waits and lower appointment attendance.
They also found that leaders did not consistently identify and support people with additional communication needs and did not ensure effective systems were in place to prevent autistic patients and patients with learning disabilities from having longer surgical waits.
The report found that the trust handled around 650 complaints a year but did not have a team dedicated to manging them. This meant that responses were often late and the quality of the responses was varied.
Although the report acknowledged that changes had been made, they had not yet made a difference.
However the report did include positive findings by the inspectors, such as how leaders worked with other local health organisations to help more elderly and frail patients receive care closer to home, as well as expanding access to scans and blood tests.
Ms Williams said: “Our inspectors did see genuine commitment to improvement. The trust had a programme empowering staff to drive real changes including practical improvements that meant people weren’t waiting as long for basic care needs to be met.
“We have shared our findings with the trusts management, who are aware of the improvements needed, including addressing the organisation’s culture.
“We will continue to monitor the trust, including through future inspections, to ensure people remain safe while improvements are made.”
The trust provides healthcare services for approximately 744,000 people across East Surrey, West Sussex and South Croydon.