- NHS hospital
Birmingham Heartlands Hospital
On 21 November 2024, we published a report on Birmingham Heartlands Hospital. The assessment looked at medical and surgery services but did not award overall ratings to these or the hospital overall. You can read the full report in the document below. We will update this page with the results of this assessment soon.
- Birmingham Heartlands Hospital assessment report (rating: not rated)
Assessment report published 28 August 2025
Contents
Ratings - Urgent and emergency services
Our view of the service
The Birmingham Heartlands Hospital emergency department is a type 1 trauma unit situated in Bordesley Green in south-east Birmingham. It provides urgent and emergency care to patients in the local area as well as northern and particularly southern Birmingham. In the 2023/24 financial year there were 150,000 attendances, approximately 400 per day with an average of 130 of these arriving by emergency ambulance.
The emergency department is 1 of 3 run by University Hospitals Birmingham NHS Foundation Trust, with the others at Good Hope Hospital in Sutton Coldfield, and Queen Elizabeth Hospital in Edgbaston.
We carried out this assessment of the emergency department on 4 and 5 March 2025. It was carried out to determine if improvements had been made following our previous inspection in 2023.
We inspected 25 quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas with scores from the last inspection to give the rating.
At the previous inspection, we rated safe as inadequate. At this assessment, the rating improved to requires improvement. Responsive stayed the same at requires improvement. Caring stayed the same at good. Well led and effective improved from requires improvement to good.
Four of the 5 regulatory breaches from our inspection in 2023 had been met, but the requirement for all staff to have appraisals had not. Because of crowding in the department, and the lack of flow meaning patients were waiting a long time both in and to access the department, we have issued a regulatory breach.
There was a strong focus on safety by staff and leaders, but external pressures and the building's size and configuration limited their ability to control risks. Due to crowding in the department caused by the demand for hospital beds, the service was not able to manage patients risks safely at all times. The environment was not fit for purpose which had a significant impact on the safety of the department, and limited leaders' ability to make improvements. There were not always enough staff to care for patients particularly with the higher demand at times of crowding.
Care and treatment were delivered against recommendations and guidance from national bodies including the Royal College of Emergency Medicine and the National Institute for Health and Care Excellence. The department took part in audits to assess and monitor the effectiveness of treatment. Patient's consent was asked for and their capacity to consent was assessed.
People were treated with kindness, empathy, and compassion. Their privacy and dignity were respected as much as possible but because of the challenges of the environment they often had a poor experience. People were able to make their own decisions and be understood. Staff were generally supported but suffered stress due to the high-pressure working environment.
The service was in breach of the legal regulations relating to safe care and treatment due to long waits, crowding and lack of flow in the department. However, there was good person-centred care, listening to patient's experiences and learning from complaints.
Leaders understood and embodied the culture and values of the workforce and the organisation. They had the skills and knowledge, experience and credibility to lead well. They demonstrated their integrity and honesty which was recognised by their staff. There was a clear system of governance and risk management based around delivering safe and good quality care and treatment.
People's experience of this service
Patients and any family or carers with them were mostly positive about the staff treating them with warmth and kindness and providing effective care and treatment.
During our inspection most said they were seen quickly when they arrived by trained nursing staff to find out more about why they had attended the emergency department. Those arriving on foot were seen at the entrance by a streaming nurse and those by ambulance in the rapid ambulance assessment area and their immediate needs quickly identified.
However, on many occasions those patients who were not in need of immediate attention waited a long time to be further assessed and treated in the department or to be transferred to another part of the hospital. People told us that the wait, particularly in the ambulatory waiting area, was often uncomfortable due to lack of space and seating and the facilities were not adequate for the number of people waiting.
Most indicators in the CQC annual Urgent and Emergency Care Survey 2024 showed the department to be performing the same as those in other hospitals.
However, the department was worse than expected for people being told what would happen next; privacy, respect and dignity; doctors and nurses listening; and feeling safe around other patients.
It was somewhat worse than expected for waiting.
The overall experience was worse than expected and no indicators were better than expected.
In information provided to us from patients in our ‘give feedback on care’ online reporting tool, we were told of concerns from patients about long waiting times, staff attitude and the cleanliness of the department, particularly the ambulatory waiting area. Some patients also raised concerns about feeling safe in the department because of the behaviour of other patients.