Calderdale Royal Hospital urged to improve staffing in emergency care
CQC inspection reveals urgent care staff under pressure due to shortages
The Care Quality Commission (CQC) has downgraded the urgent and emergency care services at Calderdale Royal Hospital from 'good' to 'requires improvement.'
Calderdale Royal Hospital, operated by Calderdale and Huddersfield NHS Foundation Trust, serves the Halifax area and its surroundings.
The inspection took place in February as part of a broader review of the trust's leadership, which was published in June.
Following the inspection, CQC maintained the rating for 'caring,' 'responsive,' and 'well-led' as 'good,' while 'safe' and 'effective' were downgraded to 'requires improvement.'
Staff concerns
Gill Hodgson-Reilly, CQC deputy director of operations in the north-east, outlined challenges faced by staff due to shortages.
"When we inspected urgent and emergency care at Calderdale Royal Hospital, we found staff were kind and working hard to meet people’s needs under considerable pressure."
Hodgson-Reilly said the lack of staffing meant staff were often unable to provide the necessary care or take breaks.
Patients reported long delays, including waits for pain relief and drinks.
There was inefficiency in timely doctor reviews and some issues with fall risk assessments.
The inspection revealed some positive steps, such as efforts to improve patient flow and a new electronic system to monitor deteriorating patients.
Summary of findings
According to the inspection report, leaders need to make several key improvements to enhance patient safety and care standards:
- Rooms for mental health patients must be made safer, addressing ligature risks and self-harm hazards.
- Security checks for visitors entering the paediatric emergency department were lacking.
- The SDEC unit’s remote location raised concerns about safety due to the absence of emergency call bells.
- Timely administration of medicines, including those critical for Parkinson's Disease treatment, was not always ensured.
- Infection prevention measures were not consistently followed.
On a positive note, staff felt supported by managers after difficult events, and cultural needs of patients were identified and provided for.
The CQC has emphasized the need for rapid improvements and will continue monitoring the hospital closely to ensure patient safety.
A reply from the Trust
Rob Aitchison, Chief Executive of Calderdale and Huddersfield NHS Foundation Trust, said: "We are disappointed that the rating for urgent and emergency care at Calderdale Royal Hospital has moved from good to requires improvement.
"While it is reassuring that inspectors recognised the kindness, professionalism and commitment of our colleagues, and again rated caring, responsive and well-led services as good, it is clear there are areas where we must improve.
"The report highlights challenges that will be familiar across urgent and emergency care services nationally, including increasing demand, patient flow and workforce pressures.
"The inspection took place during February, one of the busiest times of the year for urgent and emergency care, when services were managing significant seasonal demand. However, we fully accept the findings and are already taking action to address the issues identified."
"This report underlines why we cannot continue to do things in the same way. Through our Foundations for our Future programme, we are transforming how we deliver care, creating more sustainable services, stronger clinical pathways and better environments for both patients and colleagues.
"A key part of that transformation is the development of our new Emergency Department at Calderdale Royal Hospital. This significant investment will help us provide safer, more responsive care, improve patient flow and create facilities that are fit for the future.
"We remain committed to learning, improving and working with our colleagues, patients and partners to deliver the high-quality urgent and emergency care that our communities deserve."