Tameside General Hospital

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• 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

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

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The service planned care to meet the needs of local people, took account of children and young people's individual needs and future care plans, and made it easy for people to give feedback about their experiences. Care and treatment was centred around children and young people and their needs. Most people could access the service when they needed it, in a way that promoted equality and protected their rights.

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.

Parents and young people told us their needs and preferences were taken into account. They told us their care and treatment was person-centred and focused on their needs. Staff told us they assessed people’s clinical and personal needs with their involvement to develop person-centred care plans.

We observed positive interactions between staff and people who used the service. We saw staff understood their needs and provided appropriate care and treatment.

Care records showed staff regularly discussed people’s care and treatment with them and provided care in accordance with their needs and preferences. There was routine involvement from specialist staff (such as mental health liaison, play specialists, respiratory and dietitian specialists).

We saw person-centred care plans were in place for 16 and year olds admitted to adult beds that took into account their clinical needs and privacy and dignity needs. Individual care plans were in place for children and adolescent gynaecology. Care plans and enhanced observation records were in place for child and adolescent mental health conditions (including paediatric overdose, self-harm eating disorders, substance misuse and behavioural issues).

Care records included hospital passports for children and young people with a learning disability or mental health disorders and these included people’s preferences and choices. Reasonable adjustment care plans were put in place to support them. The play specialists also completed individual assessments and formulated person-centred care plans that were age appropriate and based on individual needs and preferences.

Care records included individual care plans for clinical needs, such as pressure care, nutrition and hydration, falls, diabetes and asthma management. Care records also included individual care plans for daily living, social needs and personal care.

Services were planned and delivered to meet the needs of children and young people. There were daily meetings with the hospital bed management team so access and flow could be monitored and maintained and to identify and resolve any issues relating to admission or discharge from the services.

Staff were aware of how to escalate key risks that could affect people's safety, such as staffing and bed capacity issues and there was daily involvement by ward managers, clinical leads and matrons to address these risks.

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Parents and young people told us their care was coordinated well and staff planned and delivered their care and treatment in a way that met their needs.

Facilities and premises were appropriate for the services being delivered. The children's unit, neonatal unit and the children and young people's emergency department operated 24 hours a day, 7 days per week. The areas we inspected were compliant with same-sex accommodation guidelines.

The theatres department had a theatre for children's surgery. There had been 1,453 surgical and non-surgical procedures carried out for people aged 18 and younger in the last 12 months. The most frequent procedures were orthopaedic, dental and ear, nose and throat (ENT) surgery and surgery for neonatal disorders. Children and young people requiring complex surgery could also be transferred to specialist regional hospitals for treatment.

The children's outpatient department had sufficient numbers of waiting areas and treatment and consultation rooms. Outpatient clinics were mostly available during routine hours on weekdays. Clinics were scheduled in advance so care and treatment could be effectively planned and delivered. Paediatric nurse-led clinics included food challenges, phlebotomy and jaundice. Medical-led clinics included general paediatrics, medical audiology, orthopaedics and ear, nose and throat (ENT).

Service partners told us the children's services had a strong focus on meeting the needs of the diverse population, particularly for children and young people with additional needs and disabilities. They told us the services worked collaboratively with local and regional partners and other service providers to support and improve people's access to children and young people's services.

Staff told us they regularly discussed and provided people with relevant information so they were well informed about their care and treatment. Parents and young people told us staff provided them with necessary information about their care and treatment verbally and in writing.

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Information leaflets were readily available. Information leaflets could be provided in different languages or other formats, such as braille or easy read format, if required.

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Staff could access interpreter and sign language services for people where required. Staff used easy read and pictorial records and tools to aid communication with children and young people.

Staff told us they received all the information they required to plan people's care and treatment. They told us they could easily access information such as care records, policies and guidance relevant to their role.

Managers produced an integrated performance dashboard which included information around performance, staffing, safety incidents, audit results and outcomes. The dashboard information was shared with staff during routine engagement and staff meetings.

Information such as policies and guidance was available in paper and electronic format. Electronic and paper-based care records were easily accessible by staff and these were held securely.

Most staff (99%) had completed mandatory training information governance and data security. There had been no information commissioner's office (ICO) reportable data breaches relating to services for children and young people in the past 12 months.

People who used the service told us they knew how to raise a complaint or concern and felt confident their concerns would be listened to and addressed.

Staff understood the policy on complaints and knew how to handle them. They told us information about complaints was discussed during daily huddles, handovers and routine staff meetings.

The hospital’s complaints policy stated that complaints would be acknowledged within 3 working days and responded to within 45 working days for routine formal complaints or within 60 working days for complex complaints requiring investigations. People who used the service were given information on how to escalate their concerns within the organisation to external organisations such as the Parliamentary and Health Service Ombudsman

The children and young people’s services received 16 complaints during the past 12 months, of which 10 related to the children and young people’s emergency department. The most frequent reasons for complaints was for delays in clinical treatment or diagnosis. All but one of the complaints were completed within the timeframe agreed with the complainant.

Staff across the children and young people’s services told us they routinely engaged with people who used the service and families to gain their feedback. This was done informally through daily engagement and formally through participation in surveys, such as the NHS friends and family test.

Friends and family test survey data between January and December 2024 showed most people rated services as good or very good; the children and young people’s emergency department (88%), children’s unit (97%), neonatal unit (100%) and children’s outpatient unit (93%). This indicated most people were positive about their experience of the children and young people’s services at this hospital.

Managers told us they reviewed complaints, compliments and feedback from surveys to aid learning and improvement. Staff were able to give examples of improvements made following people’s feedback, including purchasing a recliner chair and renovation of the parent’s room and sensory rooms in the children’s unit, making improvements in hot food availability and the procurement of secured milk storage boxes in the neonatal unit, and involving parents and young people in improving the children and young people’s emergency department environment for people with autism and complex needs.

During February 2024 to January 2025, there had been 3,106 admissions to the children's observation and assessment unit, 2,237 admissions to the children's unit and 250 admissions to the neonatal unit. There had been 23,143 children and young people's emergency department attendances and 25,968 children's outpatient department attendances during this period.

People who used the service told us they received treatment in a prompt and timely manner and did not experience long waiting times. They told us they were given clear information around appointment and treatment times.

Most people could access the service when they needed it and received the right care promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge people were in line with most national standards.

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Most people (over 99%) referred for routine diagnostic appointments were seen within 6 weeks of referral between May 2024 and January 2025. The children and young people's services also performed well for cancer wait times referral to treatment standards for first event and faster diagnosis standard (FDS) referrals during the past 12 months.

Records showed 86% of people in November 2024 and 91% in December 2024 were seen within 18 weeks of referral for surgery, which indicated high levels of compliance against the 18 week referral to treatment waiting time standard. There had been no waits longer than 52 weeks during this period.

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There had been only 3 surgical procedure cancellations in the past 12 months relating to children and young people services (due to bed unavailability). The proportion of emergency readmissions within 30 days of discharge from the children's services was 6% during the past 12 months.

The number of people waiting for new and follow up outpatient appointments was low and average waiting times for new outpatient referrals by specialty clinic ranged between 2 and 17 weeks during the past 12 months.

Managers told us the relocation of the children and young people's emergency department to the main emergency department had led to improvements in waiting times. During January 2025, 78% of people were seen within 4 hours in the children and young people's emergency department. The department completed 53% of ambulance handovers within 15 minutes and 96% within 30 minutes during January 2025. There was an ongoing improvement and transformation programme to improve hospital front door services.

Managers told us they had sufficient capacity to meet people's needs and provide timely care and treatment. Average bed occupancy at midnight during 2024 in the children's unit, neonatal unit and observation and assessment area was 53%.

The average length of stay was 1 day on the children's observation and assessment area, 2 to 3 days on the children's unit and between 6 and 13 days on the neonatal unit during the past 12 months. The services reported there had been 160 children with a length of stay over 5 days during the past 12 months. The extended length of stay was mainly due to complex admissions and people who were medically unwell for an earlier discharge.

The proportion of people who did not attend (DNA) children's outpatient appointments during 2024/25 (11.4%) was comparable to regional and national averages. Staff told us they followed up any people who did not attend their appointments.

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Records showed there was a higher DNA rate from people from an ethnic minority or those from the most deprived 20% of the local population during 2024. Initiatives taken to improve communication and engagement with these groups had led to a significant improvement in DNA rates from September 2024 onwards.

The children and young people’s services followed the trust’s equality, diversity and inclusion strategy, which stated a commitment to improving the health of the local population and reducing inequalities in healthcare provision.

Policies and procedures included equality impact assessments. Staff could access guidance, factsheets and toolkits to enable them to support people with protected characteristics such as race, gender and religious beliefs.

Staff were able to describe the processes for equal opportunities including how they ensured they did not discriminate, including on the grounds of protected characteristics under the Equality Act, when making care and treatment decisions.

Most staff (97%) across the children and young people’s services had completed mandatory training in equality, diversity and human rights.

People who used the service told us their needs and preferences were assessed and understood by staff. They told us they were treated with equality. 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 with a mental health disorder, learning disability, those identifying as LGBTQ+ and people with communication or language difficulties.

Protected characteristics were taken into account when planning for people’s care and treatment. Care records showed care plans were in place and people with specific needs and preferences and staff provided care and treatment in line with their wishes where possible.

We looked at data around incidents, complaints and outcomes and this did not identify any disparity in care experiences or inequalities for people with protected characteristics.

Parents and young people told us the staff discussed their long-term care and treatment plans, expectations and outcomes with them and their preferences were taken into account. Staff told us they planned and discussed care and treatment plans, including discharge arrangements, on admission to the service.

Staff on the children's unit and neonatal unit completed an early discharge checklist, which covered areas such as discharge medicines and communication to the person, their families and other healthcare professionals (such as GP's) to ensure people were discharged in a planned and organised manner. Complex discharges included involvements from community teams and social workers to ensure continuity of care. Discharge letters written by the doctors included all the relevant clinical information relating to the person's stay at the hospital.

Staff on the neonatal unit completed SWAN training to enable support for parents of babies on end of life care. The SWAN end of life and bereavement model of care supports staff in clinical areas to give personalised end of life and bereavement care.

Staff used advanced care plans for neonates and children's palliative and end of life care that were based on national guidelines (such as `ReSPECT'). We looked at 2 children's palliative care records and these were person-centred and included best interest decision making tools that involved staff and people's families.

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Staff told us they could seek advice and guidance from the hospital's palliative care team, including for bereavement and counselling support. A multi-faith chaplaincy service was available for spiritual or religious support to people of all faiths and beliefs.

Staff told us existing `unified do not attempt cardiopulmonary resuscitation' (uDNACPR) orders were available in children and young people's records when they were admitted to the service. We looked at 1 uDNACPR record and this was completed appropriately with involvement from parents.

The service had processes to support young people with long-term conditions such as epilepsy, asthma and diabetes when transitioning to adulthood.