William Harvey Hospital

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 that people’s privacy and dignity was respected, that they understood that 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. The rating for this assessment has remained good. This meant people were supported and treated with dignity and respect and involved as partners in their care. We assessed all quality statements.

We found that the service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. Most patients we spoke to told us they felt well-informed about their care, and that staff supported them to make informed decisions about their care and treatment. The service promoted people’s independence, since the last assessment we saw an improvement in culture within department. However, privacy and dignity was hard to maintain in some areas of the department and staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. As a result of this the service was in breach of the regulation in relation to privacy and dignity.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

The evidence showed some shortfalls. Staff mostly treated patients with kindness and compassion. However, due to crowding in the department and the difficult environment there were some concerns about patient’s privacy being always met. This was recognised by most of the staff who were doing as much as they could to support privacy and dignity for patients.

Staff conversations in the temporary escalation areas and the waiting room was not private and could be overheard during triage and private examinations. Staff were forced to discuss care about patients in front of others due to the number of people in the department and lack of space. This meant their confidential information could be overheard by others.

Staff and managers recognised privacy could be an issue at times. There was a dedicated area in the department they moved patients into if they needed to perform a procedure or needed a private conversation, but this was not always possible due to the high volume of patients being seen. These beds did not offer any screening and we saw patients bedded there overnight.

We also witnessed a patient in the escalation area having an abdominal scan with no screening which did not maintain their dignity. We also witnessed an elderly patient exposed below the waist before prompting staff to cover them up.

The CQC Urgent and Emergency Care Survey 2024 showed that for the questions in relation to privacy at reception, the trust scored somewhat worse than expected with 6 out of 10. For privacy when examined or treated the trust was worse than expected with 7.9 out of 10.

Although privacy and dignity were difficult to maintain for patients receiving care and treatment in temporary escalation areas, most patients we spoke with, although not happy with the situation, did not voice any specific concerns and acknowledged the difficult circumstances staff were working in.

Patients said staff treated them well and behaved appropriately towards them. The patient liaison team supported patients to ensure their needs were met. They also arranged for books, puzzles and other means to help with longer stays.

Patients personal, cultural, social and religious needs were considered. The chaplaincy department had staff members and volunteers representing most Christian denominations alongside all major world-faith groups in the area.

The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff demonstrated an understanding of patient needs and made use of face to face or telephone interpretation services. This benefitted individuals whose first language was not English or those requiring British Sign Language.

We saw staff talked to patients in a way they could understand and had access to communication aids (such as pictograms). A pictogram is a chart or graph that uses simple icons or symbols making information easy to read at a glance.

Staff supported patients to understand and manage their care, treatment or condition. We saw staff explaining procedures in a child friendly way in the paediatric area, ensuring children understood what was happening.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. There were several choices, including vegetarian options, 'soft foods' for patients who can find food difficult to chew, purée, gluten free, high-energy choices and a menu for renal patients. Asian, Halal, vegan and Kosher meals were all available on request.

Staff ensured that patients had access to appropriate spiritual support. Patients could access the Chaplain 24 hours a day. However, the prayer room was small and a divider was used to separate one faith area from another, which did not promote privacy. Staff acknowledged it needed to be updated.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Red mats and red trays were available in all areas to visually highlight to staff the patient needs assistance and/or monitoring at mealtimes. The Red Lid System is a red lid placed on the patient’s water jug and/or red cups/glasses to visually highlight to staff that a patient needs assistance and/or monitoring with hydration at all times.

Most patients we spoke to told us they felt well-informed about their care, and that staff supported them to make informed decisions about their care and treatment. However, we spoke with some patients who described feeling forgotten particularly in the waiting room and temporary escalation areas.

All mental health support workers and band 6 and band 7 nurses had completed Maybo training, Maybo equips healthcare teams with practical skills and the confidence to prevent and de-escalate conflict, promoting approaches that are both respectful and safe when working in close proximity to patients. This enabled staff to be equipped with the skills to manage agitation and behavioural disturbance safely using non-medical strategies wherever possible. Clinical staff also had mental health awareness and therapeutic support training.

Results from the CQC Urgent and Emergency Care survey 2024 showed that the trust performed worse than expected for the questions relating to having time to talk. The trust scored 7 out of 10 in relation to patients feeling they had enough time to discuss their condition with a doctor or nurse. The trust also performed somewhat worse than expected in relation to being provided with clear explanations about their condition and being listened to.

The evidence showed some shortfalls. The service did not always listen to and understand people’s needs, views and wishes. Staff mostly responded to people’s needs in the moment or act to minimise any discomfort, concern, or distress.

There were long waits in the department and not all patients we spoke with were aware of their plan of care. Patients waiting for long periods of time were frustrated and told us they didn’t feel communicated to. People often spent more than 12 hours in the department and staff supported them with their needs where they could, but this was not always possible.

Often patients described the noise and comfort levels being of particular concern. We also reviewed several concerns and patient contacts which identified a lack of privacy and lack of sleep through noise and lighting in the escalation areas. Staff and leaders were aware of the concerns and are constantly reviewing the use of escalation areas.

The national Friends and Family Test (2025) showed only 78% of patients would recommend the service. Waiting times, communications and quality of treatment and staff attitudes formed the majority of the negative themes. The department also received feedback from paediatric accident and emergency survey. This showed that 76% of children and young people responded that the “had a great time” or “it was okay” with 19% reporting they “didn’t like it at all”.

The trust also received feedback from Healthwatch and the patient voice team in the hospital. All information was reviewed and fed back during regular governance meetings.

However, there was a lack of review and identifying themes from patient feedback, which meant that it wasn’t always clear where improvements could be made. For example, in October 2025, the department received 1,940 friends and family feedback results. Of these only 11 were reviewed and any themes identified. The department had a theming compliance of 0.57% for October 2025 and had an overall compliance of 15.49%. That meant 85% of the responses patients sent during that time period were not reviewed and categorised by the department.

Department managers were visible and helped staff to deal with patients during busy periods. They fully acknowledged that patients were waiting for prolonged periods and had reported these concerns as risks on their daily reports and more widely on the risk register for the department.

The service had a system to identify people with mental health needs and align to the appropriate pathway. Data showed the ED performed well in triaging patients with mental health needs and providing appropriate support in accordance with their risk.

Staff mostly responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. We saw the care patients received in the resuscitation area was prompt, responsive and well-coordinated.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to deliver person-centred care.

Staff told us that there had been an improvement in culture within department. Most of the staff we spoke to reported they felt well supported by leaders and able to speak up. Staff we spoke to knew how to escalate concerns and felt happy to do so.

Staff told us that there was a culture of kindness and respect between nursing and medical teams. Staff of all grades and disciplines had protected time to attend training and study days. This included mandatory training for the team and training for extended clinical roles. All of the staff we spoke to were very positive about the training and study days.

The department had introduced a wellbeing champion programme. It aimed to embed peer based wellbeing support within the department. Alongside this, the team had worked to expand trauma-aware and advocacy-based approaches, recognising that much of the support delivered in the UEC was in response to incidents. This included the delivery of Trauma and Risk Management (TRiM) interventions following multiple critical events.

The combined staff turnover rate for UEC was on average 8% in December 2025, this was an improvement from the summer of the same year where staffing turnover went above the trust level threshold of 10%.

Sickness rates for UEC nursing staff were on average 4.7% between September and December 2025. Medical staff showed an average of 3.3% sickness rate during the same period. Both figures showing an improvement on the previous year.

Staff had access to a Management of Violence and Aggression: Supporting Positive Behaviours Policy, this included a template for letters to patients, flow charts for clear processes and included management of children and young peoples. It was detailed and outlined roles and responsibilities clearly.

Staff told us they received supervision, and clinical incident reviews and debriefs following a difficult event. Staff spoke of feeling proud to work in the department and deliver care despite the challenges they faced.

The NHS Staff survey for 2025 showed the trust scored slightly below the average median results for several of the indicators. Including compassionate leadership being recognised and rewarded, and morale.

The department had ways to collect staff feedback and reflect on staff concerns. For example, the Team Culture and Reset Workshops. These were facilitated sessions that brought together multidisciplinary teams to reflect openly on behaviours, communication, and shared purpose. Each session concluded with agreed priorities and practical improvement actions owned by the teams themselves.

There was an embedded support system and training programme which had clear objectives and monitoring. Staff praised the lead consultant nurse who ensured that only appropriately trained and competency-assessed staff undertook independent triage and streaming, with clear governance oversight and supervision arrangements in place for those progressing towards full sign-off.