Warning Notice at Derriford Hospital
The Care Quality Commission (CQC) has taken action to protect people using urgent and emergency services at Derriford Hospital following an inspection in March.
An unannounced inspection was carried out in urgent and emergency services at Derriford Hospital, run by University Hospitals Plymouth NHS Trust, following information of concern highlighted to the commission regarding access to the emergency department.
continued focus is required
Following the inspection, the trust was issued with a warning notice to make rapid and widespread improvements to keep people safe and improve access and overcrowding in the emergency department.
Urgent and emergency care at Derriford Hospital has been rated as requires improvement overall as have the ratings for safe, effective, responsive and well-led. The area of caring was not examined as part of this inspection.
The overall rating for the trust and the hospital remain as requires improvement.
Catherine Campbell, CQC deputy director of operations in the south, said:
“On previous inspections we had highlighted the pressures at Derriford Hospital being mainly due to limited availability of social care beds and community care, which impacted on the number of medically fit people able to be discharged. That hindered flow throughout the hospital, causing people to experience long delays.
“During this inspection we found people were still experiencing long waits in ambulances and the emergency department waiting room was still overcrowded. This included people experiencing long waits to be triaged, treated or discharged. One person’s relative was told there may be a 48 hour wait for their loved one to be admitted to hospital.
“However, some told us they had been assessed and treated relatively quickly. People gave positive feedback about staff, describing them as brilliant and lovely. This doesn’t alter the fact that in October 2021, we highlighted the same problems to the trust’s leadership and local stakeholders.
“There is a new leadership team in place at the trust and we are aware that emergency department delays in treatment is one of the areas that has been prioritised to improve care. But, continued focus is required on what the trust can do to improve the safety, quality and experience of care for people through the emergency department, by making the improvements required in the warning notice will focus attention on the areas we want to see significant and widespread improvement particularly regarding overcrowding in the emergency department.
“This includes focusing attention on the areas we want to see significant and widespread improvement particularly regarding overcrowding in the emergency department.
“The new leadership team were building relationships internally and externally with local stakeholders, ambulance services and GPs. Weekly meetings with the ambulance service had helped to jointly manage the high numbers of people arriving by ambulance.
“We will continue to monitor the trust, including through future inspections, to ensure the necessary improvements are made so people can receive safe and appropriate care.”
At Derriford Hospital’s urgent and emergency services, inspectors found:
- Not all staff received feedback from leaders when incidents had been raised. This led to a culture of staff being less inclined to report incidents.
- The layout of the waiting room made it difficult for staff to safely observe or hear people call out for assistance.
- The waiting room was not large enough to safely accommodate the high volume of people in the area. We saw all areas of the department were very busy and the waiting room was crowded with people in very close proximity to each other with some areas being standing room only.
- The pathway for people with mental health needs had improved. There was a dedicated nurse currently in place to support people through the pathway.
- There was better support and focus across the trust which meant that departments were able to work together more effectively.
The full reports will be published on CQC’s website in the next few days, on the hospital page: