Dorset County Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

This means we looked for evidence that the service met people’s needs. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

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

We scored the service as 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff and leaders kept people at the centre of their care and treatment choices, working together to meet patient needs in the ED environment and for their onward care journey. There were 18 incidents of slip, trip and falls events reported by staff in ED between October and December 2025. Incident records showed staff protected the dignity of patients who wished to retain as much independence as possible. Although this sometimes resulted in falls, especially when patients needed to access the toilet, this rarely resulted in injury.

There were effective systems for digital flags and referral which meant patients were more likely to access specialist support earlier in their care journey. Staff said specialist teams and services were responsive when they requested support for patients who needed adjustments. This included access to learning disability teams and play specialists from the children's ward. Staff said paediatric play therapists were always available when needed and provided essential support when managing difficult conversations. Also, ED staff had access to 4 learning disability advocates who were available to provide immediate support and advice. Patients identified with a learning disability and or autism received an Emergency Department or ward visit, and subsequent review of their hospital notes if admitted.

Staff across the ED were trained, supported, and equipped to utilise available quiet spaces for patients experiencing distress. Patients were treated with compassion and dignity. Staff shared a recent example of how teams worked together to care for a patient who arrived distressed in ED. The ED was not a suitable environment for this patient due to their vulnerability and needs. ED staff arranged for the patient to be brought to the Health and Wellbeing, Information, Volunteering and Engagement (HIVE). The patient received 1 to 1 support from volunteers while ED staff managed their care and treatment. Teams coordinated additional support from other services such as, the learning disability team, social work and mental health liaison to provide individualised care.

In the CQC Urgent and Emergency Care (UEC) Survey 2024, patients using this service reported having slightly better experiences of care and treatment and interactions with doctors and nurses than patients cared for at other trusts. Patients had better than expected quality of communication about why they had any tests and the results were explained in a way they could understand.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service considered the needs and preferences of different people, including those with protected characteristics under the Equality Act and those at most risk of a poorer experience of care. Leaders did this by ensuring they worked in partnership with other teams in the trust and engaging with external stakeholders across the Integrated Care System (ICS). Decisions about improvements to the service were informed by sensible consultation processes, keeping people who used their services at the heart of this. For example, following higher levels of attendance from young people with social, emotional and mental health needs, the trust developed a dashboard to accurately monitor this risk and were developing multi agency care plans to support earlier interventions and prevent reattendance or admission.

ED leaders had a strong understanding of the population their service cared for, including the seasonal variation due to their geographical location. There were processes to ensure important information was safely shared with relevant healthcare services, bodies and social support organisations. This included information such as social concerns, safeguarding concerns and advanced decisions on resuscitation made in the community or in primary care. Reception staff were able to explain how they accessed this information and recorded this as digital flags on patient care records. ED leaders used tools such as digital flag registers to make informed decisions tailored to local need and demand. This meant the service were able to take timely action and prepare for peaks of activity such as from local tourism or respond to changes in patients reattending due to a pre-existing health condition. Also, if patients were unable to, or forgot to share relevant information, this should be flagged with teams.

However, this did not always work as intended. Following a complaint from a patient who did not have timely access to a BSL interpreter and had difficulty communicating with staff, the trust invited people from the profoundly deaf community to understand their lived experience and how to effectively improve future experiences of care. One of the recommendations was to improve the use of digital flags to distinguish between those who were hard of hearing and those with profound deafness. This resulted in the launch of improved translation services, and the patient shared positive feedback of earlier access to interpreting services during an ED reattendance.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information was provided in forms accessible to a range of patient needs. The trust website contained a virtual tour of the Emergency Department. This was presented in an easy read format to ensure information was understandable, usable and inclusive. The trust provided information leaflets available in languages spoken by patients.

Due to the improvement works in progress, wayfinding signage was not always easy to read or fully reflective of the patient pathway through ED. Senior leaders at trust level were aware of this and had consulted a specialist wayfinding service to make improvements trust wide. This was due to widespread inconsistency in signage and required a tailored strategy to ensure improvements met the needs of the people who used and worked at the hospital. Also, some patients with learning disabilities or autism said signage was hard to understand and it was not easy to find their way around the hospital. In the meantime, the ED service used greet and guide volunteers to support patient wayfinding for the relocated walk in ED front door. There was a blue line visual guide to support patients who needed to visit the main ED following triage in the walk in ED. We observed patients using this during the inspection.

Posters were present in both the walk in and main ED areas, promoting initiatives such as call for concern and think privacy. ED areas were equipped with hearing loops, legally required under the Equalities Act 2010.

On the day of inspection, most staff we spoke with, were aware of how to access translation and interpretation services and were able to share examples of when they had done so. Staff were able to access these services via telephone or Information on Wheels (IOW) trolleys. There were arrangements for accessing British Sign Language (BSL) interpreters to attend the ED at short notice. However, during the onsite inspection, some reception staff reported using google translate to communicate or had asked the patients’ family member or friend to translate from another language.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result. However, complaints were not always responded to in a timely way.

When patients complained or raised concerns, they received feedback. However, the trust did not always achieve this in the timeframe they planned to. There were 28 complaints received between November 2025 and January 2026. The most common theme was communication failures. Of these, 22 complaints were suitable for early resolution in line with trust policy and national guidance from the Parliamentary Health Service Ombudsman (PHSO). However, only 1 of these were resolved and closed within the recommended 10 working day timeframe. This was due to the trust shortening the recommended timeframe from 40 to 10 working days in December 2025 to bring hospital policy in line with PHSO guidance and technical challenges with digital tools. The limitations of digital tools and their impact on complaint response times was recorded to the trust risk register. The trust were designing a new training package to support staff to resolve complaints earlier.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Between February 2025 and January 2026, the hospital was often operating under major pressure. The NHS framework used to measure and manage acute hospital pressure is called Operational Pressures Escalation Levels (OPEL), ranging from level 1, normal operation, to level 4, major incident. The hospital mostly operated at OPEL 3, with brief periods where their performance improved to OPEL 2. There were no days where patient demand matched the capacity and the hospital had not needed to declare a major incident where patient safety was at risk. The hospital consistently and effectively used complex system wide actions well to ensure safe care and treatment continued to be delivered and avoided redirecting patients from the front door.

The service had made significant improvements to spaces designed for vulnerable patients in times of mental health crisis since the last inspection. This promoted the safety of patients who needed this service and staff who cared for them. The mental health suite consisted of 2 specially designed rooms and an observation suite, for patients with mental health concerns. These had been built and maintained in line with national standards such as Psychiatric Liaison Accreditation Network standards and RCEM estate standards. The risk of a patient using the fixtures and fittings as a ligature had been managed well and blind spots had been addressed. There were also low ligature risk hygiene facilities next to this suite with an anti-barricade door fitted.

Staff and leaders promoted the use of reasonable adjustments and recorded this to patient care plans where possible. Carers were encouraged to stay with patients overnight if they wished to and there were compact foldable beds available for this purpose.

However, there were some access limitations for emergency eye services and as a result people had to travel to another hospital for care and treatment. Emergency eye services were available Monday to Saturday, but unavailable on a Sunday.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. However, there remained improvements to be made for people with profound deafness.

Staff and leaders recognised which patients were at greatest risk of inequity in the ED environment. The service used data, internal and community patient experience forums to understand who was at greatest risk of poor experiences and outcomes and worked together to improve this. Mental Health Care Support Workers (MHSW) were recruited to the ED due to increasing attendances of patient with mental healthcare needs. MHSWs worked across all shifts to provide both physical care and enhanced therapeutic observation and care (ETOC) with therapeutic activities appropriate to individual preferences or needs. The service worked with NHSE to develop their ETOC strategy and rolled out a pilot for this in all areas of the hospital from February 2026.

The trust used the Friends and Family test questionnaire to collect information about experiences of care. The response rate was low with no responses shared in October 2025, improving to 2.2% of patients in December 2025. Most patients responded they would recommend their care and treatment, but the ED performed worse in this area compared to other departments in the trust such as inpatient and maternity care. Leaders stated this was likely due to the questionnaire being mostly paper based and had arranged for an electronic anonymised feedback service to support this.

Patient ethnicity was recorded in ED for 79% of electronic care records, below the 95% national average. This increased to 93% when patients became an inpatient. There were multiple patient administration systems and trust level senior leaders were collaborating with system partners to develop a single electronic health record across Dorset and Somerset. In the meantime, the service developed guide cards to support patients who may prefer not to say, or be asked in a public space, to indicate ethnicity and other protected characteristic by choosing using visual cues.

Staff and leaders actively listened to the most vulnerable people using their services. There were a variety of ways for patients and members of the public to share their experiences, such as through the weekly carer café, the blind and partially sighted group and the HIVE. Meeting records showed people with a diverse range of needs and characteristics shared feedback on their experience of the ED. However, we heard of 2 poor experiences of care and treatment in ED from the profoundly death community. Some patients experienced barriers to communication, which affected their ability to understand and engage with their care. Further to improvements in translation and interpreter services, senior leaders were considering undertaking a 15 steps challenge to ensure the new ED building met the needs of the deaf community. The 15 steps challenge is a tool used by NHS services designed to help services and the people who use them to evaluate the quality of healthcare environments and identify areas for improvement.

We scored the service as 2. The evidence showed some shortfalls. DNACPR decisions were not always made by the medical or nursing staff with the correct level of seniority however, people were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Medical care inpatient audits including the Emergency Department between October to December 2025 showed the decision on DNACPR was not always made by medical or nursing staff with the correct level of seniority and training in line with trust policy and not all audited records showed a consultant had formally approved the DNACPR decision within 48hrs of admission. Although the trust was assured DNACPR and TEP decisions were individualised, there was limited assurance of improvement as some ongoing improvement actions had no identified completion dates. Additionally, processes for reconciling community DNACPR forms with the hospitals’ systems could only be completed by medical staff due to access limitations to GP health records. There were sometimes delays in ED medical clerking for completion of patient health and care records, which presented a risk of cardiopulmonary resuscitation being given to a patient who did not want this. However, there were no reports of this type of incident.

Patients who presented at ED with palliative care needs were supported by the right staff and teams to enhance their quality of life and return home if they wished to. The trust wide end of life team worked with patients in ED to provide supportive care for patients who presented with new symptoms or a new diagnosis. The team developed a pilot to introduce suitable patients with acute palliative care needs to the Acute Hospital at Home (AHAH) service. The focus was to provide patients with the choice to access care and treatment in their preferred environment, whether this was at home, at a hospice or as inpatient care. There were significant opportunities to reduce unnecessary inpatient focused care and improve patient experience as over half of the patients who took part in the pilot presented with palliative symptoms in ED. One case showed staff were able to undertake three times a day visits to support the patient in their own home which promoted their choice and social needs. Some patients did not want to use AHAH and chose to be cared for in a hospice, or as an inpatient.

There were dedicated quiet areas offering patients and their families privacy and space during sensitive situations. This included areas such as Gully’s place suites, a home from home accommodation for families of children and young people who were critically unwell, receiving palliative care or had died in the ED. This service was provided by a charity who provided specialised medical and therapy equipment, resource materials for memory making keepsakes and bereavement support groups. For patients who had experienced miscarriage, the ED team identified preferred spaces within the high care unit which offered maximum privacy and dignity. Sometimes, this space was not available due to other patients requiring enhanced care and treatment. When this happened, the nurse in charge identified an alternative area, or arranged a cubicle swap where possible.