Russells Hall Hospital’s A&E rated as failing in damning report

That damning appraisal came as the Care Quality Commission concluded the Dudley Group NHS Foundation Trust needs to improve.

Its overall ‘requires improvement’ rating is the same as in its previous inspection four years ago.

• READ the CQC report here

But the CQC report downgraded rankings for effectiveness and leadership, which were good in 2014 but now need to improve.

Inspectors levelled the harshest criticism at the trust’s urgent and emergency care.

The CQC’s chief inspector of hospitals, Professor Ted Baker, said: “Our main concerns were with what we found in the urgent and emergency services, which we rated as inadequate overall.

"Triage processes were inconsistent and not exercised in line with the trust policy or national guidelines.

“Patients attending the emergency department did not always receive robust and sufficient assessment of their clinical presentation and condition.

“This posed a significant risk that life threatening conditions would not be identified and treated as quickly as they should have been.”

The report said: “We found cases where patients had suffered serious harm because of lack of implementation and compliance with recognised systems.”

Professor Baker said the trust also needs to improve staffing levels and described its governance as ‘not robust’.

Mrs Diane Wake, trust chief executive said: “It is pleasing to see inspectors found our services to be caring overall. We are disappointed our emergency department has been rated inadequate especially given how hard our staff have worked.”

What does the inspection report reveal?

Senior staff out of touch with reality and patients put at risk of harm – just some of the failings found at a hospital trust which has been ordered to improve.

Inspectors from the Care Quality Commission have said they are ‘disappointed’ with the performance of The Dudley Group NHS Foundation Trust.

The trust has been ranked as ‘required improvement’ overall by the health watchdog.

It was also told to improve in the inspection categories for safety, effectiveness, responsiveness and leadership – but rated as good for being caring.

Inspectors blasted urgent and emergency care at the trust as being ‘inadequate’.

But they highlighted areas of outstanding practice in maternity and community services, with the area ranked good overall.

The report said: “The emergency department was not providing safe, effective and responsive care and treatment and the care and treatment provided at times exposed patients to the risk of avoidable harm...

“Patients presenting to the emergency department did not always receive robust and sufficient assessment of their clinical presentation and condition.

“This posed a significant risk that life threatening conditions would not be identified and treated as quickly as they should have been.

“We saw examples of patients who had deteriorated unnoticed due to the lack of robust assessment.”

The trust operates acute hospital services from three sites at Russells Hall Hospital, Corbett Outpatient Centre and Guest Outpatient Centre.

It also provides community services in facilities across Dudley, and parts of Sandwell. South Staffordshire and Wyre Forest.

Inspectors wrote: “Governance systems were not robust and did not ensure safe and effective care was being delivered.

“The culture within the department was not open and senior staff did not recognise significant areas of risk and potential harm to patients...

“Senior staff within the service were out of touch with the reality of the quality of care and treatment provided in the department.”

Trust chief executive Diane Wake said: “Our emergency department has an improvement plan in place which will support the staff to deliver the safe quality care they all aspire too.

“We are very proud of our community services whose overall rating was good and the team found examples of outstanding practice.

“We are really pleased with the improvements in maternity services which mean they have been rated good overall and that our medical care including how we care for older people also remains good with a stroke service that is one of the best in the region.

“Our staff are committed to making all of the improvements necessary on our journey to become outstanding.

“The inspectors could see there had been improvements in the incident reporting process since their last inspection and that staff could demonstrate learning.

“They also received excellent feedback about how the team have tailored services to meet the needs of individuals and processes in place to keep patients safe.”