- NHS hospital
The York Hospital
Report from 1 July 2024 assessment
Contents
Ratings - Urgent and emergency services
Our view of the service
Urgent and Emergency Care Services at The York Hospital are provided by York and Scarborough Teaching Hospitals NHS Foundation Trust. We conducted an on-site assessment visit to The York Hospital urgent and emergency care services from 14 January to 15 January 2025. We carried out this assessment in line with our routine assessment priorities, due to the previous rating of inadequate for this service. Following this assessment, we rated the Urgent and Emergency Care Services as requires improvement.
We assessed 25 quality statements for the safe, effective, caring, responsive and well-led key questions. Our inspection was unannounced (staff did not know we were coming) to enable us to observe routine activity. During our inspection we spoke with patients and relatives. We observed staff delivering care and looked at patient records. We reviewed trust policies and performance information from, and about, the trust. We also spoke with members of staff including all grades of medical and nursing staff, housekeepers, administrators and domestic staff. We also spoke with the leadership team.
While improvements had been made since the last assessment, we identified breaches of regulation in relation to safe care and treatment, and premises and equipment.
There was a lack of space to accommodate the numbers of people attending the department and patients were not always cared for in an environment that was suitably designed to meet their needs. Care records were not always fully completed and staff lacked confidence in completing the risk assessment tool for patients with a mental health need. Daily checks on emergency equipment did not always happen and chemical substances were incorrectly stored. There were key risks associated with staffing numbers in the paediatric department. People did not always receive timely care and treatment.
However, the service had a positive safety-focussed culture. Safety incidents and complaints were managed well and lessons learned. Care was planned and organised with people and stakeholders to maintain safety and continuity of care. The service controlled infection risks well. Staff planned and delivered care according to best practice and national guidance. Staff treated people with compassion and kindness. Leaders had the skills and experience to carry out their roles.
We have asked the provider for an action plan in response to the concerns found during this assessment.
People's experience of this service
Patients, their family, and carers were positive about interactions with staff and the treatment they received in the emergency department. All said they were treated with compassion and kindness. Patients’ felt communication was good and that they were informed of care options and treatment plans. Patients and their families felt there was adequate and visible staff in the department, and that it was clean and tidy.
People generally could access care, treatment and support. On arrival at the emergency department patients who had walked in were assessed quickly but they reported long waits for a bed when admission was required.