Arrowe Park 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

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

During our assessment, we saw patients deconditioning whilst spending long periods of time being nursed on trolleys and waiting room chairs once a decision to admit had been made. The service did not make sure that people could access the care, support and treatment they needed when they needed it. There were delays in patients accessing therapy services such as speech and language and dietetics. The trust did not always respond to complaints within the appropriate timescales. However, people told us their needs and preferences were assessed and understood by staff. They told us they were treated in a non-discriminatory way. The division made adjustments for people with disabilities and communication needs.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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 supported patients living with dementia and learning disabilities by using ‘this is me’ documents and patient passports that included the dementia flower. The medical wards achieved 91% compliance for patient centred care in the last 6 months.

The service made reasonable adjustments to allow additional visiting for some patients, for example, those in the last hours of their life, or who required a carer due to their condition. The service used signage to indicate if patients were at end of life and tried to provide a side room for them.

Staff understood and applied the policy on meeting the information and communication needs of patients with a disability or sensory loss.

We observed an area which had been adapted to meet the needs of dementia patients on ward 21. This included a dayroom that was decorated in the style of a public house with a piano and furniture.

Managers made sure staff, patients, loved ones and carers could get help from interpreters or signers when needed. Interpretation, advocacy and cultural support was provided by a community organisation that was based within the hospital Monday to Friday. The service was also available out of hours including weekends.

Patients were given a choice of food and drink to meet their cultural and religious preferences.

We visited the discharge lounge where patients waited for transport after they had been discharged. Patients were offered hot and cold drinks and if there were long delays waiting for their transport then food was offered.

We scored the service as 2. The evidence showed some shortfalls. There were some shortfalls in how the service understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

During our assessment, we saw medical care patients deconditioning whilst spending long periods of time being nursed in the emergency department corridors. Patients were spending more than 50 hours on trolleys and waiting room chairs once a decision to admit had been made due to no beds being available on the wards.

We were told that the speech and language therapy service was under a service review due to difficulty in staff recruitment. In the last 6 months, the average wait time for an inpatient speech and language therapy assessment was 4 days. However, at the time our assessment this had increased to 7 days. This meant patients did not receive swallowing and dysphagia assessments in a timely manner.

For dietetics, the average wait time for an urgent referral was 2 days and a routine referral was 3 days. However, we were told the service could not always achieve these times due to demand or staffing capacity.

Staff were aware of the need to report breaches of the standards for mixed sex accommodation. There had been 14 reported breaches in the coronary care unit in the last 12 months.

Leaders for the division planned and organised services, so they met the changing needs of the population. For example, senior leaders told us the same day emergency care model had been designed using a multidisciplinary approach involving consultants across the division including the acute frailty unit. Following the successful implementation of SDEC a business case had been approved to extend and have an additional area for trolleys.

The division had access to the transfer of care hub who supported with patient’s discharges from hospital.

The trust had developed a Patient Engagement Strategy for groups of individuals who had diverse health care needs. The trust held engagement events, focused workshops and direct meetings with a variety of organisations and charities to ensure they had a comprehensive understanding of the needs of their members and to adapt trust services and improve patient centred care.

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.

Staff received training in data security and were aware of the importance of managing information responsibly and confidentially.

The division made adjustments for people with disabilities, communication needs, and for people whose first language was not English.

Information we reviewed about patients met data protection legislation requirements.

Information such as policies and guidance were available on the trust’s intranet.

In 2025, the trust decided to commission its non-verbal language interpretation separately from the spoken language interpretation to better meet the needs of patients. This was a response to patient feedback and engagement. The trust had contracted with a third-party provider created by the local deaf community. This service enabled patients to book their own British Sign Language (BSL) interpreter for a routine or emergency appointment. It provided a portal which kept the patient informed about their upcoming appointment and details of their support coordinator. Patients were able to provide feedback regarding the interpretation service during their appointment.

Trust data showed that from April 2024 to March 2025, 5652 interpretation sessions had been provided for inpatients and outpatients across the trust.

We scored the service as 2. The evidence showed some shortfalls. 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 or tell them what had changed as a result. However, the trust did not always respond to complaints within the appropriate timescales.

Patients, relatives and carers knew how to complain or raise concerns.

From November 2024 to April 2025 the service received 28 formal complaints and 454 concerns. The top three complaint themes for the division were clinical treatment, communication and medication. We reviewed the trust performance of responding to complaints over a 6-month period prior to the assessment date and found that only 40% of complaints were responded to within the appropriate timescale.

All staff we spoke with could articulate the complaints and compliments process and would proactively share this information with patients.

The service clearly displayed information about how to raise a concern in patient areas. The service had a patient experience team and displayed information to direct patients how to make a complaint if they needed to.

Complaints were investigated by senior leaders within the service. Managers would share complaints and compliments and any learning with all staff through face-to-face meetings, newsletters and emails.

When complaints were received, they were progressed through a governance structure. To maximise learning, complaints and feedback data was triangulated with multiple sources of available information supporting the identification of themes and trends. This informed the development of strategic plans, maximising impact, and outcomes. In addition, complaints were incorporated into the trust’s patient safety incident response data analysis, informing the annual Patient Safety Incident Response Framework (PSIRF) plan.

The trust expedited the roll out of Martha’s Rule to ensure that there were clear routes of escalation available when families or carers had concerns regarding clinical deterioration of their loved one. In addition, the trust was actively working with a neighbouring NHS community trust to improve communication pathways between teams and support care delivery.

We scored the service as 1. The evidence showed significant shortfalls. The service did not make sure that people could access the care, support and treatment they needed when they needed it.

Managers did not always ensure that patients could access services when needed to receive treatment within agreed timeframes and national standards.

Data from quarter 4 2024/2025 showed that the division had an average performance of 71% for meeting the 28-day faster diagnosis standard. This was below the national standard of 75% and below the regional average which was 77%.

For the same period 89% of cancer patients received treatment within 31 days of referral from their GP. This was below the national standard of 96%, below the national average of 91% and below the regional average of 94%. In addition, 73% of patients received treatment within 62 days of referral. This was below the national standard of 85% but above the national average of 68% and above the regional average of 72%.

Senior leaders told us that a recovery plan had been implemented to focus on supporting improvement in the 28-day faster diagnosis standard with the anticipation that it would also support improvement against the 31 day and 62-day standards.

At the time of our assessment, the average length of stay for elective and non-elective admitted patients at the hospital was 7.6 days. However, we saw evidence of patients who had spent several months on the medical wards and were medically fit for discharge.

Bed management meetings were held 4 times per day. However, bed management processes did not operate effectively to ensure patient flow was maintained. During our assessment we identified empty beds across multiple wards that had been allocated to patients in the emergency department who were clinically unwell to move. These beds were not reallocated to other patients. Transfers were not always timely to de-escalate pressure in the emergency department. Senior leaders told us that at the time of our assessment IPC cleans were taking place on a number of medical wards which resulted in temporary bed unavailability for short periods until completion.

Staff did not always plan patients’ discharge in a timely way. This was evident from the number of patient discharges after 5pm. Trust data showed that in the last 3 months, 852 patients were discharged from the hospital after 5pm. An audit of 49 discharges recorded between 11pm and 8am in the last 3 months showed that around 82% of discharges occurred during normal working hours and there was an administrative delay in recording the discharge on the electronic system.

Staff moved patients between wards at night. Trust data showed that from February to April 2025, there were 200 bed moves after 8pm within the division at the hospital. The trust conducted a review of the 200 bed moves and findings showed that the moves were driven by clinical need, escalation requirements and efficient use of available capacity.

Significant demands on services caused medical outliers (patients who were cared for in a different speciality area to their own needs) across the wards meaning care was not always being delivered to patients by the right ward speciality. At the time of our assessment there were 28 medical outliers across the wards. However, all outlying patients were included on a daily report which was shared each morning and visible to the consultants covering each area. This ensured that clinical responsibility was clear, and that patients were reviewed as part of daily ward rounds. Where a patient required more specialist input, the appropriate specialty team was involved to provide review and care planning.

Managers told us the patient with no criteria to reside list was monitored daily, i.e. patients who were medically optimised for discharge, but awaiting a discharge, usually with support from other services. In addition, there were weekly meetings to review those patients who had a long length of stay. At the time of our assessment 10.8% of patients identified as having no criteria to reside. This position was better when compared to other NHS trusts in Cheshire and Merseyside.

The transfer of care hub was a multiagency team hosted by the trust. The hub comprised staff from the trust, a neighbouring NHS community trust and the local authority. The hub dealt with complex patient discharges for those patients on pathways 1 to 3. For example, patients who required bed-based rehabilitation, patients discharged home who required additional support and patients who required packages of care. The hub produced a weekly no criteria to reside and long length of stay report which included data, themes, trajectories and actions.

From our observations and discussions with staff the transfer of care hub was working well and doing everything reasonably practicable to discharge patients. However, it was evident that the medical wards were not proactive in preparing patients for discharge. Staff told us that barriers to patient discharges included patients awaiting medical reviews and medical wards not using the online portering system appropriately.

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.

People told us their needs and preferences were assessed and understood by staff. They told us they were treated in a non-discriminatory way.

Staff told us they treated people equally and without discrimination. They were able to give examples of how they respected the individual wishes of people with protected characteristics, such as those identifying as transgender and people with communication or language difficulties.

The provider’s equality and diversity policy outlined the processes for equal opportunities including how staff ensured they did not discriminate, including on the grounds of protected characteristics under the Equality Act, when making care and treatment decisions.

We scored the service as 2. The evidence showed some shortfalls. People were not always 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.

In quarter 1 of 2025/2026, the resuscitation services lead for the trust presented a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) report to the Patient Services Quality Board (PSQB). The report included data from the trust’s business intelligence team and clinical audit team. Since June 2023 the resuscitation services lead received a daily report of new entries inputted into an online system for DNACPR. The resuscitation services lead identified areas of non-compliance and followed this up with the clinical department or team who provided care for the individual.

Results from the DNACPR audits were presented at PSQB and was inclusive of Mental Capacity Act application within the DNACPR compliance report. However, information within the report highlighted concerns relating to DNACPR and MCA compliance. Data showed that patients were not always having the required MCA and best interest assessments completed when concerns were raised regarding patient capacity.

We saw no evidence of an associated action plan to show that concerns were being addressed appropriately.