THINGS have got slightly better at Dudley's emergency department since concerns around patient safety were raised but improvements still need to be made, especially regarding ambulance hand over delays, a new report by the Care Quality Commission says.

An inspection was carried out a month ago to check how the urgent and emergency service at Russells Hall Hospital, part of The Dudley Group NHS Foundation Trust, was responding to winter pressures and the findings have today (Thursday April 1) been published in a new report by the CQC.

The inspection, on February 2, focussed on patient safety, infection prevention and control, patient flow, workforce and leadership and culture.

An acceptable level of care was found to be provided, a report from the inspection said, and trust leaders had made some positive changes in response to concerns raised, but the visit did not result in a change to the rating for the emergency department which still Requires Improvement as does the trust overall.

The inspection did, however, result in a slight uplift to a rating assessing whether services in the emergency department were safe. The trust previously received an Inadequate rating for this category but it now Requires Improvement.

Bernadette Hanney, CQC’s head of hospital inspection, said: “When inspectors visited the urgent and emergency service at Russells Hall Hospital, they were pleased to see that most areas were providing an acceptable level of care to ensure patients’ needs were being met.

“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 and gave inspectors examples of recent occasions where they had been supported to do this."

But she said patients brought by ambulance often experienced delays at times of increased demand and data from the three weeks prior to the inspection showed the trust had been worse than the national average for ambulance hand over delays.

She added: "Whilst hospital staff prioritised these patients, they relied on ambulance personnel to escalate any concerns or deterioration in the patient’s condition.

“Trust leaders responded to these concerns and have made some positive changes. These include; deploying a doctor to the ambulance entrance area to work alongside a triage nurse, ensuring early clinical assessment is completed and treating and discharging patients directly from the ambulance if appropriate.

“Inspectors reported their findings to the trust leadership, which knows what it must do to bring about further improvements and ensure it maintains any already made.”

Diane Wake, chief executive of the Dudley Group, welcomed the report following the inspection which she said was unannounced and she said: "We are really proud of the work our teams have delivered and their dedication and commitment to providing safe, effective care for all our patients especially throughout the global pandemic.

"We are pleased the CQC found our staff felt respected, supported and valued. This comes alongside the recent news that the Trust is in the top ten nationally for most improved results from our staff survey.

"We are committed to continuing our journey, highlighting our areas of best practice and supporting teams striving to provide the best care.

"We have addressed the recommendations in the report and continue to work with our partners across health and social care to ensure our emergency department and all services are safe and effective."

Following the inspection, the trust must now make a number of improvements.

The report calls for continued work to improve staff compliance with safeguarding training. It says the trust should consider implementing a system that includes visual prompts at red area access points to remind staff of PPE requirements before entering. It also calls for the trust to work with the wider health and social care system to improve flow from the emergency unit to speciality wards; and says the trust should consider taking a more proactive and integrated approach with assessing and managing the risks associated with ambulance offload delays.