Queen Elizabeth Hospital Birmingham

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that people were always treated with kindness, empathy and compassion. We checked people’s privacy and dignity was respected, they understood they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

At our last assessment we rated this key question good. At this assessment, the rating remained as good. This meant people felt well-supported, cared for and treated with dignity and respect. Most people, and all those we met on the visit said they were treated kindly, although some direct feedback to us described people not feeling they received compassion from staff. Staff listened to people and their needs and did their best with the pressures on demand to meet them. The leaders cared about their staff and their wellbeing, and again, with the pressures on the service much of the time, did their best to support them.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service mostly treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated their colleagues and those from other parts of the trust or other organisations with kindness and respect.

Almost all the people we met said staff treated them well. People were able to maintain their dignity as much as possible, and staff were kind and acted with respect in interactions we observed. One patient told us they had a “really good experience here today.” They said they were “very grateful to all the staff.” They reported how their plan for onward care was shared with them in detail and was all well understood. Another patient who had been referred to the medical same day emergency care department by their GP found the service “brilliant.” Tests had been arranged and carried out quickly. They said staff were “really lovely.”

However, some people had contacted us in the months before this inspection and said staff were not kind to them, so this was not the experience for everyone. One patient told us they had not had a good experience so far. They said nobody had answered their call bell as they were “all too busy with computers.” The patient had no update on any test results and said they felt they had been “abandoned.”

Most people told us they felt safe with staff, and they would respond to their needs quickly and efficiently. However, some patients said staff were known to be exceptionally busy and sometimes they were not attended to as quickly as possible. Patients mostly said staff responded quickly if they were in pain or discomfort. However, some patients who described their experience in the department when responding to our annual patient survey of emergency departments said pain relief was not always timely. Some people described waiting for many hours in the waiting area and not getting basic pain relief.

People were fairly sure their information was treated in confidence and staff respected their privacy. One patient said they had no reason to think everything discussed or written down was not confidential and staff were not sharing information about them without their permission. Another relative said, “I would hope they would know what we are telling them is very private. They do seem to get that.” People also said staff knew enough about their preferences, wishes and personal histories to act in their best interests.

The staff mostly listened to and understood people’s needs, views and wishes. Staff usually responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Nursing staff each individually looked after a small number of patients which enabled them to better understand people’s needs and wishes. One trainee nurse we met had a good history and understanding of a patient they were looking after and described them well. The information matched what had been recorded in the patient’s notes. Staff were able to find out how to support people to meet their immediate needs. This included finding ways to communicate with them effectively.

Staff were able to support patients and relatives in distressing events. They said they were enabled to have time to look after friends and relatives of a patient who had sustained serious or life-threatening injuries. They were able to keep them updated and felt they had the skills to deliver bad news when this was necessary.

The trust’s ‘vulnerabilities’ clinical nurse specialists were involved in the department and came each day to review patients who might have extra needs. They mentioned how it was often hard to find quieter places for those patients who found the busy nature of the department raised their anxiety, but everyone did their best.

There were limited options for staff to record in a patient’s notes if a patient preferred a different name or different pronouns. This could be made known in the patient’s narrative notes but might not be easily spotted. We met a patient who used a different name and pronouns to those in their medical records, but those they had chosen were not used in any interactions by staff who did not pick up on the new details.

There were some small things staff could have acted upon to support people. For example, 1 frail elderly patient we met had no power left on her mobile phone and had not been able to contact their family as a result (they had been in the department in the corridor outside the resuscitation bay overnight). There had been no attempt by the staff to make sure the patient had a way to contact their family.

Although the senior staff cared about and promoted the wellbeing of their staff and supported and valued them to deliver person-centred care, the 2024 NHS Staff Survey for the emergency department had some concerning results. This included just 3.9% of staff who responded (51 staff or 17% of the team) who reported they did not feel worn out at the end of their shift or working day. This was against a trust average of 18.8%. In the last 12 months, 31.4% of the staff who responded to the 2024 NHS Staff Survey said they felt unwell as a result of work-related stress. Almost 70% of staff said they came to work sometimes in the previous 3 months although not feeling well enough. We recognised this related to responses from just 17% of the staff team, but most of the results were nevertheless much below the trust’s averages.

There was a varied view from some staff who sometimes did not feel valued or part of the team. Nevertheless, most staff felt they were able to provide feedback and suggest ways to improve the service or staff experience. In the 2024 NHS Staff Survey, 88.2% of staff in the emergency department who responded (51 staff) agreed or strongly agreed their role made a difference to patients. This was slightly better than the trust average of 87.2%. However, in contrast, just 26.5% of those who responded to the 2024 survey said they would recommend the organisation as a place to work. The trust average was 53.2%.

Staff said they were mostly able to get breaks, but at some of the busiest times it was not always easy. Some staff who were more remote from others in the large footprint of the department said they often failed to get breaks as there was no one to cover them. We heard some of the senior nursing staff checking on their teams to see if they were due a break; had something recently to drink; or if they needed anything more generally. Staff told us there was a good flexible working policy and approach to supporting them with a work/life balance as much as possible.

When we asked some staff if they felt they would get support if they were struggling, both nursing and medical staff, they all said they felt they would. Doctors told us they were well supported in terms of their wellbeing by the consultants. An international doctor said how they had been helped to settle in and given time to adjust.

Most staff said they felt valued. This was particularly evident with the domestic and portering staff we spoke with who felt part of the team and their work was recognised as important. They had a sense of belonging. However, some staff felt less valued than others. Staff who were working within the footprint of the urgent and emergency care department but in other areas outside of majors told us they did not always feel valued or listened to, which we fed back to senior leaders in the department.

Staff who worked on the reception desks at the hospital had a panic button if they were feeling anxious about patients’ behaviour. They said they were often confronted with aggressive or angry patients but had usually a quick response from security staff who were located in the department.

There were newsletters for staff but no information otherwise on noticeboards or elsewhere showing celebratory information for staff, which otherwise might have been a boost to their morale. There was a wellbeing hub for staff, but the 4 staff we asked about this service were not able to describe where it was or how they could access it.