Russells Hall Hospital's emergency service still 'requires improvement', say inspectors

Patients arriving to Russells Hall Hospital in Dudley by ambulance faced an increasing number of delays of more than 30 minutes between June and December last year, the report by the Care Quality Commission said.

And between August and December last year there were ‘consistently high’ numbers of turnaround times that exceeded an hour. As a result the department has now deployed a doctor to the ambulance entrance area to help ease pressures.

The watchdog said the hospital should also consider taking a more “proactive and integrated approach with regards to the management of the risks associated with ambulance offload delays.”

The targeted inspection did not result in a rating change for the urgent and emergency service overall, which remains at requires improvement – while the rating for safety at the urgent and emergency service, previously inadequate, has moved up to requires improvement.

The report said: “Data showed patients arriving to the hospital from ambulances experienced delays in being admitted to the emergency department.

"From June 2020 to December 2020 the National Ambulance Information Group data shows there was an upward trend in the monthly percentage of ambulance journeys with turnaround times over 30 minutes at Russells Hall.

"Between August 2020 and December 2020 there were consistently high numbers of turnaround times that exceeded 60 minutes.

"Increased ambulance turnover times means there is a risk that people in the community who dial 999 may experience delays in receiving ambulance care.

Dedication

"Emergency department and trust leaders told us they had responded to concerns. This included, deploying a doctor to the ambulance entrance area to work alongside a triage nurse, ensuring if appropriate patients could be treated and discharged directly from the ambulance.”

Improvements the trust should make include achieving improvements in staff compliance with safeguarding training; implementing a system that includes visual prompts to remind staff of PPE; and continuing to work with the wider health and social care system to improve flow from the emergency department to speciality wards.

Bernadette Hanney, the CQC’s head of hospital inspection, said: “Staff told inspectors that despite the increased pressures from the pandemic, they felt respected, supported and valued by their leaders. They were able to raise and escalate concerns.”

The report also said the service controlled infection risk well; staff kept equipment and the premises visibly clean; staff completed risk assessments for each patient swiftly and identified patients at risk of deterioration.

Staff also followed safe infection control principles including PPE. The overall CQC rating for the trust remains at requires improvement.

Diane Wake, chief executive of the Dudley Group NHS Foundation Trust said: “We are really proud of the work our teams have delivered and their dedication especially throughout the global pandemic.

"We are pleased the CQC found our staff felt respected, supported and valued.

“We have addressed the recommendations in the report and continue to work with partners to ensure our emergency department and all services are safe and effective.”