Scunthorpe General Hospital

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service did not manage the risk of infection. The training provided was comprehensive, but the service did not ensure that all staff completed it. The service enabled people to raise concerns. Managers investigated incidents thoroughly and people were protected and kept safe. The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff involved people in planning changes.

We have not awarded this service a score for Safe.

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

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff we spoke with were able to tell us how to raise concerns, and how to record incidents on their internal system. Staff told us they were encouraged to report incidents and there was a no blame culture.

Staff told us incidents were essential for learning and learning was shared in staff meetings. Learning from incidents and any themes or trends would be shared in the daily huddles that were held within the department. Senior staff led daily huddles each shift for both medical, nursing and allied health staff. Information shared included learning from incidents, recent safety alerts and details of operational demand. The department has designated clinical educators who held ad-hoc and planned teaching sessions for staff.

Staff we spoke to understood the need to be open and transparent when things go wrong. They told us they knew where to access the duty of candour policy. This policy was in date and version controlled. Duty of candour is the legal responsibility for healthcare providers to be open and honest with patients, and their families, when something goes wrong with their care that has caused, or could have caused, harm or distress.

The trust had a complaints and concerns handling policy, which was in date and version controlled. We reviewed complaints from Urgent and Emergency Care which were managed in line with trust policy and responded to within the allocated timescales. The service shared investigation findings and were open and transparent where failings had been identified. The service shared areas of learning and gave assurances to the complainant that action would be taken to prevent errors occurring again.

We saw examples of staff and service users being listened to and their views being considered. For example, staff told us they were consulted on the layout of the new department. We saw that staff were working to ensure that the new department was being used in the most effective and safe way possible to care for patients. This included reviews of designated areas to ensure they held the most appropriate patients.

The evidence shows some shortfalls in the timely assessment of patients who self-presented to the department.

Patients would enter the department either through the public main entrance or via a separate ambulance entrance. A streaming system was in place which enabled patients to be seen in the most appropriate place within the department. The children’s emergency department was separate from the main department areas.

Flow and capacity in and out of the department remained a concern to leaders and staff. Senior leaders discussed flow and capacity several times throughout the day to manage capacity within the department.

The department had a patient flow and escalation policy, which was in place to manage the risk when the department was under pressure. The department had a risk register which included the risk of poor flow through the department and the service not always being able to meet target waiting times.

Initial 15-minute triage times were not consistently met. The average waiting time, based on data provided for October to December 2025, was 45 minutes. People who required specialist clinical assessment were not always seen within the 4-hour national target. Staff told us specialty teams did not always to carry out a face-to-face review of patients in the department when the patients were waiting long periods for an inpatient bed. This often led to delays and poor continuity of care when patients moved to the wards, especially wards that were at a different site. Leaders acknowledged work was needed to ensure patients received a timely specialist review, whilst in the department, as this was contributing to prolonged wait times.

The trust was awaiting the implementation of a new electronic patient record system service wide. They told us this would allow for greater continuity of care and reduce incidents of medication errors within the department.

The service shared concerns quickly and appropriately and had a mechanism for alerts in place. However, the service did not ensure that all staff had the required level of training for their role.

Safeguarding supervision training, which is part of the services mandatory training, did not meet the trust target across all workforce groups within the department. The trust target was 85%. Medical staff compliance was at 30%, and nursing staff compliance was at 62% as of January 2026.

Medical staff compliance with safeguarding training did not always meet the trust target of 85%. The training data we requested showed 67% of medical staff completing safeguarding children level 3 training and 67% completing safeguarding adults level 3 training. The training data we requested showed nursing staff had met the trust target of 85% for compliance in adult (86%) and children (87%) safeguarding level 3 training.

Non-clinical staff were aware of the level of safeguarding training they had completed. Reception staff we spoke with told us they had also completed safeguarding training and would escalate any concerns to nursing staff. The training data we requested showed administrative and clerical staff had met the trust target of 85% for compliance in adult (92%) and children (96%) safeguarding level 1 training.

People attending Urgent and Emergency Care were booked into the service’s computer system. Administration staff told us they had robust processes for checking safeguarding concerns for adults and children. Any safeguarding alerts would be flagged on the digital system to alert staff.

The service had safeguarding policies and procedures that were date and version controlled. Staff in the department were able to demonstrate a good understanding of child and adult safeguarding processes. Staff could explain lines of escalation when they were concerned, how to complete referrals and how to take appropriate and immediate action when needed.

We saw that the hospital safeguarding leads provided a visible presence within the department. This allowed for greater levels of support and guidance for department staff and staff also told us they knew who to escalate to. Internal audits were undertaken to ensure all safeguarding alerts were completed as appropriate. We reviewed the most recent three alerts as part of data requests, which demonstrated consistent compliance.

We saw that the hospital safeguarding team provided a visible presence within the department. This allowed for greater levels of support and guidance for department staff.

We did not observe any interactions that required restraint or restrictive practice.

The service worked with people to understand and manage risks by thinking holistically. Staff assessed and managed risks to patients.

Staff used a nationally recognised tool to identify deteriorating patients and escalate concerns appropriately. Vital signs were recorded and National Early Warning System (NEWS2) scores and Paediatric Early warning Score (PEWS) to detect and respond to any clinical deterioration. The scores and required escalations were automatically calculated on the electronic system. The service had a clear escalation policy for the deteriorating patient.

We reviewed 10 patient records and found consistent and timely recording. We saw effective oversight of registered nurses in each section of the department. No patient observations were overdue, and all patients we reviewed were escalated appropriately. However, we requested copies of internal audits from the department that related to NEWS2, there were significant amounts of audits overdue. This meant we could not be assured of consistent oversight within the department by leaders.

Staff completed risk assessments for each patient on admission. We reviewed 10 patient records and saw assessments were completed thoroughly and risks that were identified on were actioned. We observed medical and nursing staff discussing patient risk in handovers and huddles.

We saw that completed audits consistently highlighted repeated issues and we saw no evidence of effective action being taken to address this. For example, we saw that pain assessment was regularly audited but remained an issue, however most patients we spoke with reported no issues with the assessment and treatment of pain.

Leaders told us they were expected to undertake audits of patient care during their shifts to ensure all risk assessments had been completed and appropriate actions taken. However, they told us that increasing workloads meant they were not always able to complete these audits in a timely way. This meant there was not always assurance that patient care within the department was being monitored effectively.

There was a mechanism on the electronic patient record system that alerted staff if a patient had a history of safeguarding, or a mental health concern. We saw examples of patient passports being available within the emergency department to enable awareness to staff of specific patient need and we were told these were used to help involve patients/relatives/carers about their care.

The service did not always detect and control potential risks in the care environment. They did not always make sure equipment, and facilities supported the delivery of safe care.

The department has undergone recent redesign and refurbishment. Staff told us the department had improved care delivery and oversight of patients. However, the paediatric waiting area was not compliant with national standards. There was limited audio and visual separation from the adult waiting area. There were blind spots in the paediatric waiting area, meaning reception did not always have full oversight of the patients waiting. We raised this with senior leaders during the inspection. They were aware of the issue but were unable to provide assurance or explain why it had not been addressed. We also noted that it did not feature on the departmental risk register.

Patients felt the waiting area was busy and lacked space to accommodate the amount of people attending the emergency department. During inspection we saw more patients waiting than the waiting room could accommodate. There was a lack of seating, we saw there were several chairs that had been removed due to being broken. We were told new seating was on order for the department.

We reviewed the equipment stored in the department and found most items were in date. There was a process to manage stock and staff reported having the equipment they need to do their jobs.

We reviewed emergency equipment that would be used in the management of patients exposed to contamination or infectious agents. We saw multiple examples of filers for respirators that were out of date and could not be considered appropriate for maintaining staff safety. We escalated this during the inspection and received assurances that it would be immediately actioned.

The department was visibly clean and participated in clinical environmental audits.

The designated mental health assessment room was occupied at the time of assessment, we were told the room is fully Psychiatric Liaison Accreditation Network compliant.

All clinical and non-clinical waste was managed appropriately. All sharp disposal bins were managed appropriately.

The service did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

The mandatory training for staff was comprehensive and when completed met the needs of patients and staff. The training covered topics such as infection prevention control, moving and handling, fire safety, equality diversity and inclusion, health and safety and information governance. However, we were not assured that all staff kept up to date with their mandatory training. Overall compliance for all staff groups was 76% against a trust target of 85%.

Data provided showed areas of concern in the completion of resuscitation training. We saw that 79% of medical staff and 61% of nursing staff had completed advanced life support training. Data showed that medical compliance with ReSPECT authorship training was 33%.

The department did not have enough Registered Paediatric Nurses. We were told this was mitigated by additional training of Registered Adult Nurses in paediatric competencies. Data provided showed 41% of medical staff and 71% of nursing staff had completed advanced paediatric life support.

We were told all newly qualified staff members had a protected supernumerary time period when first starting to work in the emergency department.

Senior leaders calculated and reviewed the number and grade of nurses, nursing assistants and healthcare assistants needed for each shift using a safer staffing tool. This assessed acuity and dependency twice a year to provide evidence-based decision making on workforce requirements. The department did not always meet the required staffing number for Registered Nurses, due to a combination of long and short-term sickness. The service’s nursing staff sickness was 9% which was worse than the national average. The services medical staff sickness rate was 2%.

The data provided showed an overall absence rate of 12% for nursing. The absence rate for doctors of all grades was 3%. Leaders and staff told us that the fill rate for nursing was over-established, however due to the overall absence rates there were gaps in the rota. We were told that this was addressed by staff picking up shifts and staff being redeployed from other areas in the hospital.

All non-permanent staff we spoke with told us that they had a full orientation on their first shift in the emergency department.

The service did not manage the risk of infection. They did not control the risk of infections spreading.

We saw some staff failing to use personal, protective equipment (PPE) correctly and saw staff coming out of cubicles and not removing their PPE before commencing additional tasks. We also noted a lack of handwashing from all grades of staff within the department.

We reviewed audit results following inspection and found that all environmental audits provided had highlighted repeated issues with hand hygiene, noncompliance with bare below the elbow and the incorrect use of PPE. These were consistent issues for the department over the last 6 months.

The evidence shows some shortfalls in safe systems and processes.

We reviewed a departmental sepsis audit undertaken from September to December 2025 which showed that 67% of patients were screened within 30 minutes, 26% had documented escalation, and 83% received hourly fluid balance on time. Blood cultures were timely in 76% of cases, with 3% of patients receiving two sets, and 81% of antimicrobial prescriptions followed guidelines.

Staff we spoke with told us that the department did not have designated pharmacy lead. This is not in line with recommendations specified by the Royal College of Emergency Medicine.

Data provided showed that 52% of medical staff had completed medicines management training. Nursing staff were at 100% compliance.

We reviewed the data from the most recent controlled drugs audit and saw compliance was 76%.

Controlled stationary, such as paper prescriptions, were stored securely and monitored to ensure they were handled in line with trust policy. The audit showed 100% compliance, however it was last completed in March 2025, meaning we could not be assured this was reflective of the current time period.

We reviewed departmental audits on the safe and secure storage of medicines. The audit had several overdue actions. Some of which reflected what we saw on assessment, for example oxygen cylinders were not always safely and securely stored.

Documentation reviewed showed detailed recording of regular medicines and allergies.

Governance structures were in place for the management and review of patient group directions (PGDs). PGDs are written instructions to facilitate the supply or administration of medicines to patients, without a prescription. We did not observe any PGDs being on assessment.

The service had systems in place to support learning from safety alerts and incidents. Department managers were aware of incidents and gave examples of learning.