Midland Metropolitan University Hospital

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This is the first assessment for this service. This key question has been rated good. This meant people were supported and treated with dignity and respect and involved as partners in their care. However, the wellbeing of the workforce was often not being addressed due to the pressures of work.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

Staff in the service treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect although maintaining privacy was sometimes difficult.

The Midland Metropolitan University Hospital opened in October 2024. The most recent CQC Urgent and Emergency Care Survey for the trust, which was based on fieldwork from 2024, was undertaken at the previous emergency departments and therefore not used for this assessment.

When we spoke to patients, although they were often frustrated by delays and crowding in the department, they were almost always positive about their experience with staff. We heard that staff were “great”, “fantastic”, “kind” and “caring”. When we saw care being given, we saw staff interacted in a kind and caring manner and spent time with patients despite being under considerable pressure to carry out clinical tasks.

Staff treated patients in consideration of their privacy and dignity and for the most part the configuration of the department supported this with assessment and treatment taking place in rooms and cubicles. However, the main waiting room was frequently crowded and without easy access to private spaces some conversations took place in public areas. This was also noticeable at the main reception desk, where, despite there being barriers and notices other patients were often within the hearing of those talking to the reception staff.

The trust collected NHS Friends and Family Test data through an electronic system that prompted patients by text to complete an electronic form. Results were shared with the department.

We saw audits which identified that relatives of people who had died in the department experienced compassion, sensitivity and good communication. During our assessment visit we saw relatives of people who were very sick being given good support and care.

Staff at the service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service took account of people’s individual needs and circumstances and made where possible made reasonable adjustments. There were polices that covered equality, diversity and inclusion and staff operated within them.

There was a good understanding of the needs of people with neurodiversity, and the trust was engaged with an external provider for mandated autism and learning disability training. However, this provider had been unable to provide the amount of training required and alternative approaches were being scoped.

With the permission of patients, family members and carers were involved in discussions about care and treatment. This was particularly in the context of ensuring discharge into a safe home environment.

The trust’s chaplaincy services were available 24 hours a day and accommodation was made for specific religious and cultural needs should a patient die while in the care of the department.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment, and wellbeing.

Patients were given choices over their treatment, within the bounds of clinical guidelines and good practice. Treatment option and the benefits and risks of different choices were explained.

Staff welcomed the support of visitors and carers who could act as advocates for patients. When a patient was unable to make an informed decision, where possible, and with the patient’s assent, carers or relatives participated in discussions.

These conversations were recorded in the patient’s notes and when significant decisions were made, such as for Do Not Attempt CardioPulmonary Resuscitation (DNACPR), the correct processes were followed and documentation completed.

Staff at the service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern, or distress. However, at many times there was insufficient suitable seating for all patients.

Patients were asked how they preferred to be addressed and staff wore name badges so they could be identified.

Patients were afforded their basic care needs while in the department including food and drink and toileting. We saw that when people had problems other than their clinical needs staff helped them. An example we saw was help given contacting people for a patient who needed to make arrangements for urgent childcare and had no telephone. There were plenty of toilets and they were kept clean.

Despite the waiting area being large and well equipped, at many times people could not find a place to sit. There were often seats available, but these were in an area of the waiting room which was typically used by police or prison officers who were accompanying patients. Other people chose not to use this area meaning the space was unused.

People usually had their pain assessed and treated promptly. The department had learned from patient feedback that pain was not always dealt with promptly by moving some pain medicines into triage rooms so they could be immediately provided. However, we still saw some patient feedback that pain was not always promptly assessed or treated.

Staff responded promptly to requests for help, although fulfilling that request could sometimes take longer than desired because of the workload in the department.

Arrangements for chaperones were available if requested by patients.

While managers at the service cared about and promoted the wellbeing of their staff, they were not always able to address the issues caused by working under high pressure and in an over-capacity service.

Staff told us they felt respected supported and valued. However, they also expressed concern about the staffing changes being implemented as part of the revised clinical model.

Staff were proud of the department, its work and their colleagues. They were open and honest about shortfalls in the service but not negative about working in the department.

While there were clear roles and accountabilities, staff told us they were able to raise concerns at any time. No member of staff told us they would be reticent to do so.

We obtained sickness figures of 5.8% for May 2025 which were comparable to the overall trust number of 5.6% and within the expected range for an acute trust. However, staff and managers told us that long term sickness due to stress was a problem, and some staff had left due to stress.

The department offered support to staff following stressful or distressing incidents and Schwarts Rounds took place. Schwartz Rounds are structured, confidential meetings for healthcare staff to discuss the emotional and social challenges of their work. Staff told us they worried about the safety of patients, and some told us they were particularly worried about the ‘front door’. By which they meant the main waiting room and the triage of patients. This was because delays could mean sick patients were not recognised.

A frequently raised concern by staff was violence and aggression in the department. Early on in our assessment visit senior managers told it was one of the 3 most concerning risks, and they were showed how they were addressing it. There were initiatives to educate people as to the inappropriateness of their behaviours through posters and if necessary individual engagement. The latter involved letters warning of conduct and eventually to seek healthcare elsewhere.

However, the focus was on providing a strong security presence in the department together with training. The trust employed security staff directly who reported, through supervisors, to a security manager. These staff were well trained and in turn were providing breakaway training to all patient-facing staff in the department. Most incidents were deescalated verbally, and this was helped by the continuity that directly employed staff brought.

There was a high level of reporting of incidents and figures showed that 40% of incidents happened in the Emergency Department. The security department made good use of this information to analyse the times and types of incidents, and they adjusted the staffing accordingly.

There was a staff room away from the main clinical area where staff could take their breaks. This area had tables, chairs and lockers.