Royal Derby Hospital

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We assessed 7 quality statements within well-led. Following this assessment well-led is rated as good.

There was a shared vision, strategy and culture. Staff were passionate about their work and responsive to the needs of people. There was a focus on patient safety and care.

There was confidence in leadership and staff felt supported by managers. There were processes in place to support staff who required reasonable adjustments.

Staff enjoyed working on the unit and worked well together as a team. Management had a visible presence on the unit.

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.

The trust had a clear shared vision, strategy and culture and this appeared to be embedded within the unit.

All staff on the unit were passionate about their work and responsive to the needs of people. The culture of the unit focused on patient safety and care. It was clear from speaking with staff that they had confidence in leadership, and they reported feeling supported by their teams and managers.

Staff felt supported by their managers and that management were regularly present on the unit. There was support available for staff who had been involved in an emotional or difficult situation.

Leaders followed processes and guidance in place to support the needs of staff who required adjustments such as flexible working.

All updates relating to the unit and any learning from incidents were communicated through work email, which all staff had access, to in addition to verbally and through the notice boards on the unit. This ensured that all staff had access to any important information.

Leaders met regularly to discuss governance across both Royal Derby Hospital and Queens Burton Hospital to ensure that both sites worked collaboratively, whilst recognising the differing needs of each unit. It was clear from speaking to leaders that they understood the needs of the unit and that they had the skills and knowledge to lead effectively.

There were processes and guidance in place to allow leaders to manage poor culture or behaviours which may impact the quality of care provided.

The trust had a Freedom to Speak Up Guardian team and Champions who staff were able to contact. A Freedom to Speak Up Guardian is a named person in every hospital trust who can provide independent support and advice to staff that want to speak up. They hold the board to account if it failed to focus on the patient safety issue. There was a process for staff to follow if they wanted to use the freedom to speak up service, information about this was available on the trust intranet. There was a freedom to speak up policy in place to support this process.

Staff felt able to raise any concerns with their leadership team.

The service valued diversity within the workforce and we saw evidence of this whilst on the unit. There were policies and procedures in place to ensure the service was inclusive to both staff and people accessing the service. All processes in place had an equality impact assessment.

The trust had staff equality networks in place to support staff with protected characteristics and contact details for these were available to staff.

Where individual risk assessments for staff had been completed there were processes and guidance in place to support leaders make reasonable adjustments for staff.

There was a clear governance structure in place with regular governance meetings taking place. Risks were reviewed regularly, and management and senior staff were aware of the risks listed on the risk register. The priority risks were communicated to staff on the learning and sharing board. Leaders welcomed suggestions for positive changes from staff.

The unit submitted data for national benchmarking with all other critical care units. Regular audits to monitor safety and risk were completed by senior staff with the most up to date data displayed on the unit.

Staff and leaders worked well with other critical care units in the Midlands network to ensure that they were able to provide a high standard of care. They understood the importance of reducing delays when admitting and discharging patients. They told us that they utilised the Adult Critical Care Transfer Service to allow timely transfers outside of the trust without impacting the staffing levels within the unit.

Staff and leaders understood their role within the midlands network and the importance of cohesive working to ensure safe care for people. We were told of an incident where a paediatric patient required critical care which is not usually provided at Royal Derby Hospital. Due to a shortage of beds in the network the service was able to assist and facilitate care for the patient until a time where it was suitable to safely transfer the patient.

There was a focus on continuous learning, innovation and improvement across the service. Staff told us that information was sent by email but also followed up face to face in team meetings and on the learning and sharing white board. If there was individual learning this would be shared with the member of staff face to face on a one-to-one basis.

When an incident had occurred which was rated as moderate harm or above a learning on a page would be completed and shared with staff.

Consultants held regular intensive care focussed training sessions with the medical team.

Staff told us that they were informed of changes but not always involved in discussions around the changes.

Leaders were aware of the challenges faced by the unit and had clear ideas for service improvements. We were told that they recognised the importance of people having access to a psychologist following admission to the unit and the team were considering how to access this.