Tameside General Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Our rating of effective stayed the same. We rated effective as good.

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Staff worked well together for the benefit of children and young people. They assessed their needs, advised them and their families on how to lead healthier lives and supported them to make decisions about their care. Staff followed national guidance to gain consent. Most children and young people experienced positive outcomes following their care and treatment.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Admission policies were in place to provide guidance for staff around the assessments required on admission to the service.

Children and young people presenting at the children and young people’s emergency department were triaged by paediatric trained staff and placed on care pathways depending on their clinical need.

Staff sought advice and support from mental health liaison specialists when providing care and treatment for children and young people presenting with psychological disorders or mental ill health. Care records showed people presenting with mental health or phycological disorders such as depression, anxiety, eating disorders, and behavioural problems received timely psychological assessments and behavioural observation charts were completed by staff where required.

Staff carried out an assessment of people’s needs upon admission to the children’s unit and neonatal unit. This included information such as contact details, medical history, social / lifestyle history and daily living assessments. Staff completed risk assessments for each person on admission and care plans were put in place where risks were identified. Staff carried out routine observations and intentional rounding checks on people at regular intervals during their hospital stay.

Consultant led ward rounds took place on a daily basis on the children’s unit and neonatal unit. The children’s unit and neonatal unit also operated a ‘consultant of the week’ model to facilitate continuity of care.

Parents and young people told us staff carried out assessments on admission to the service to identify key risks and took into account their needs and preferences. The care records we looked at were complete and up to date and showed people’s needs were assessed and risk assessments and care plans were routinely reviewed and updated with involvement from people who used the service.

Clinical guidelines and pathways were based on national guidance, such as from The National Institute for Health and Care Excellence (NICE) and the Royal College of Paediatrics and Child Health. We reviewed a number of care pathways, including for asthma, epilepsy, acute abdominal pain and eating disorders and found these were based on best practice guidance.

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Staff used the national paediatric early warning system (PEWS) and neonate early warning system to assess and respond to any change in people's condition, in-line with national guidance.

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Managers told us changes to clinical practice, national guidance and policies were reviewed and developed through routine audit meetings and clinical governance meetings and shared with staff.

The service had undertaken compliance reviews to assess compliance against NICE guidelines, such as overweight and obesity management (NG246), neonatal infection: antibiotics for prevention and treatment (NG195) and epilepsies in children, young people and adults (NG217). Action plans were developed where full compliance against standards had not been achieved and these were reviewed at routine clinical audit meetings.

Staff told us policies and procedures reflected current guidelines and were easily accessible in electronic and paper format. We looked at a selection of the policies, procedures and care pathways and these were up to date and based on current national guidelines.

Parents and young people told us staff gave pain relief medicines when needed and pain symptoms were managed appropriately. Care records showed staff used nationally recognised pain score tools, monitored people's pain symptoms and prescribed pain relief medicines when required.

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Staff made sure children and young people had enough to eat and drink including those with specialist nutrition and hydration needs. Staff used nationally recognised screening tools to monitor people at risk of malnutrition. Where people were identified as at risk, staff completed fluid and nutrition charts.

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Specialist support from staff such as dietitians was available for people who needed it. Parents had access to designated breast milk fridges and mothers were encouraged and supported with breastfeeding. People told us they were given a choice of food and drink and their nutritional needs were monitored and assessed by staff.

We saw there was effective daily communication between multidisciplinary teams across the service. Daily staff safety huddles and handover meetings took place to ensure all staff had up-to-date information about risks and concerns. Staff at all levels took part in routine multidisciplinary team meetings to plan and deliver safe care and treatment.

People who used the service spoke positively about the way their care and treatment was coordinated. They told us all staff worked well together as a team.

Mental health liaison services were available 24 hours per day. Social worker and community nursing teams were available to assist with people being discharged from the service. Staff told us they received good support from pharmacists, physiotherapists, dietitians and diagnostic support services such as for x-rays and scans. Most specialist support services were available during weekdays with on-call arrangements during out of hours and on weekends.

Care records showed there was routine input from nursing and medical staff and allied health professionals in the delivery of people’s care and treatment.

Service partners and stakeholders told us the teams worked well together around services for children, such as special educational needs and disabilities (SEND) and long term conditions.

People who used the service told us they received good support from staff and were provided with information around healthier living. Staff told us they routinely discussed health promotion and lifestyle choices with parents and young people.

Health promotion information was displayed on notice boards and in information leaflets that were readily available across the areas we inspected. People could be referred to specialist hospital or community based services for support with smoking cessation or alcohol or drug abuse.

People identified with weight concerns were given advice on healthy eating and were referred to dietitians or signposted to specialist support services.

Parents and young people who used the service spoke positively about the quality of the care and treatment they received.

The children and young people services participated in 4 national clinical audits and 6 local clinical audits. Findings from clinical audits were reviewed during monthly paediatric audit meetings and clinical governance meetings and any changes to guidance and the impact that it would have on their practice was discussed.

Outcomes for most people who used the service were positive, consistent and met expectations, such as national standards.

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The services achieved high levels of compliance across most indicators in the national asthma audit (November 2024) and the national audit of seizures and epilepsies in children and young people (Epilepsy 12) (July 2024).

The national neonatal audit programme (NNAP) audit 2024 (based on 2023 data) showed the neonatal unit was comparable to other services nationally for indicators such as non-invasive respiratory support, retinopathy of prematurity (ROP), delayed cord clamping and for prescribing antenatal steroids and magnesium sulphate. There was an action plan to improve compliance in indicators not meeting national standards or benchmarks, such as for parental presence on consultant ward rounds and early breastfeeding standards. The audit findings showed improved compliance over previous years and the preterm optimisation group had been established to review preterm cases on a monthly basis and target areas for improvement.

The services were flagged as a clinical audit outlier in the 2022-23 national paediatrics diabetes audit (NPDA) for case-mix adjusted mean HbA1c (average blood glucose levels). The clinical audit lead told us they had implemented improvement actions and were confident the service would no longer be a clinical audit outlier when the next audit data set was published.

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Improvement actions included establishing a joint diabetes transition clinic since 2023, improving foot screening and assessment processes and the appointment of an additional consultant with specialist interest in paediatric diabetes in September 2024. A business case for an additional diabetes nurses was also in progress.

The service completed an audit in November 2024 to assess staff compliance with NICE's recommendations for ‘meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management (NG240)'. The audit identified good staff compliance in standards around initial assessment, taking blood cultures and blood sugars, undertaking correct investigations and computed tomography (CT) scans and antibiotic choice and duration.

The audit also identified areas for improvement in some standards such as taking throat swabs, commencing IV antibiotics within 1 hour of meningitis being suspected and post-discharge follow-ups for bacterial meningitis. The service had developed action plans and guidelines and policies for staff to aid learning and improvement.

Model hospital data (2024/25) showed the trust was flagged as an outlier for tibia fracture admissions where no surgical procedures were undertaken for children under 17 years of age. The services reported the higher percentage flagged with no procedures was due to the low number of tibia fracture admissions and no significant concerns were identified. There had been 23 tibia fracture admissions during 2024, of which 16 underwent surgery and 7 received non-surgical treatment in agreement with the child or their parents.

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Model hospital data (2024/25) showed the trust was flagged as an outlier for emergency admissions within 30 days following tonsillectomy procedures under the care of an ear, nose and throat (ENT) surgeon. The trust conducted a review of procedures undertaken during September to December 2024, which showed 30 people were discharged following tonsillectomy and 5 were readmitted (including 1 readmitted twice). The review did not identify any themes or areas of concern. Readmission rates were continually monitored as part of getting it right first time (GIRFT) forums.

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Staff had the appropriate skills and knowledge to seek informed verbal consent and written consent before providing care and treatment. Staff gained consent from people for care and treatment in line with legislation and hospital policies for children to consent to examination or treatment.

Staff sought parental consent for young children receiving treatment. Staff we spoke with understood how to seek consent from young people using the Gillick competence guidelines. Informed verbal consent was clearly recorded in the care records we looked at. Parents and young people told us staff clearly explained what they were doing and asked for verbal consent when delivering care and treatment.

Written consent was sought for surgical procedures and some diagnostic procedures. Care records for surgical and minor outpatient procedures showed written consent had been obtained and the risks and benefits were discussed with the young person or their parents or carers prior to treatment. The consent for surgery audit (2024) on the children’s unit achieved 100% compliance, indicating high levels of staff compliance with consent policies.

Staff understood the legal requirements of The Mental Capacity Act 2005 for young people over 16 years of age. If a young person lacked the capacity to make their own decisions, staff told us they sought consent from an appropriate person that could legally make decisions on their behalf (such as a parent, carer or appointed court of protection representative).

Staff told us they could seek support and guidance around consent, mental capacity and best interest decision making processes from the hospital-wide safeguarding team.