Hull Royal Infirmary

On this page

• 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

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to Requires Improvement. This meant people’s needs were not always met.

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The evidence showed an inconsistent standard. The service did not always demonstrate that people were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

We saw an inconsistent approach to the completion of risk assessments, during the inspection we saw staff completing all appropriate risk assessments and documenting appropriately but when we reviewed previously completed patient notes we saw omissions.

We found an inconsistent approach to the recording within patient notes. We saw examples of care plans that lacked evidence of patient input or personalised goals and incomplete or generic records that didn’t reflect changing needs or preferences.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

All staff could articulate how their local communities had diverse health and care needs. All staff could give examples of patients who had varying level of need and could describe how they would accommodate them. This included patients with chronic and long-standing conditions that required a different approach.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The service was previously in breach of the legal regulation in relation to providing information. Improvements were found at this assessment and the service was no longer in breach of this regulation.

All staff were able to describe how they made notifications to external bodies such as the local authority for safeguarding issues and to the UK Health Security Agency (UKHSA, previously Public Health England) for notifiable illnesses.

At the previous inspection we saw issues around information security, namely computers left unlocked. At this inspection we saw all computers locked when not in use and any other patient information was secured.

The service complied with the Accessible Information Standard. We saw the department consider varying levels of need to ensure equitable access across all patient groups.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. Information was readily available throughout all patient areas.

The information provided was in a form accessible to the patient groups such as easy-read form and other languages.

Staff made information leaflets available in languages spoken by patients.

Staff ensured carers and families were regularly updated about the patient’s progress. Recent patient survey reported that 90% of survey patients and carer’s felt able to speak with staff regarding their health and care.

The evidence did not show full adherence to the complaints policy, limiting assurance that complaints were resolved and learning shared without delay, despite people being able to give feedback easily

We reviewed complaints received in the three months prior to inspection and saw that the trust target for the resolution of complaints was only met in August 2025 where it achieved 86% compliance against the trust target of 85%. In June 2025 it was 0% and in July 2025 14%.

All patients were given the opportunity by staff to give feedback, and staff would assist any patient to make a complaint or raise a concern.

We saw examples of feedback provided to patients who had complained or raised concerns.

Feedback was actively encouraged, and equal import was given to both good and negative feedback as it was an opportunity to learn and to improve.

Staff were able to articulate the process and their role in how to handle complaints appropriately.

Staff received feedback on the outcome of investigation of complaints and acted on the findings. Any learning from complaints was discussed during safety huddles and was also disseminated by email to ensure all staff had access.

The evidence failed to show a good standard. The service was unable to ensure that people could access the care, support and treatment they needed when they needed it.

The average time spent in department was 6 hours and 51 minutes which was significantly worse than the national average.

We did note that 10% of patients left the department without being seen, which was higher than the national average of 5%.

The percentage of patients admitted, transferred or discharged within four hours of arrival at the trust was consistently lower than the England average with the trust performance at 43%, compared to 63% at regional level. The trust also didn’t meet the aspirational standard of 78% in the previous 12 months.

In the 12 months preceding inspection all ambulance patients had an initial assessment within 31 minutes of arrival to the department and walk in patients received an initial assessment within 21 minutes.

The unplanned reattendance rate was at the national average of 9%.

We also noted that the time spent greater than four hours but less than 12 and time more than 12 hours waiting for a bed following decision to admit was an improving picture on the previous 12 months.

Evidence from the past 12 months showed previous shortfalls in this area. Recent evidence indicated improvement, with good standards developing. Staff and leaders now actively listen to people most at risk of inequality and tailor care, support, and treatment accordingly. Further work is needed to fully embed and sustain these improvements.

Staff survey results from 2024 had highlighted areas of concern with no staff responses showing improvement and all scores below average.

All staff reported improvements since the recent senior leadership changes.

We saw examples of how the new management team wanted to develop patient voice and use it to drive forwards change and sustainable growth.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. We saw a proactive approach across all staff grades within the department to encourage feedback from all patients. They used a variety of tools to ensure all patients were given equal opportunity to raise concerns and for that information to be used.

All staff had the opportunity to undertake training in equality, diversity, inclusion and human rights.

The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

We saw examples of staff supporting patients to make decisions about their care and treatment and their future. We saw the use of treatment escalation plans which were completed with patients.

Staff were able to articulate how they would care for people who are nearing the end of their life and how they would ensure that it was managed and communicated in a sensitive and dignified way.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. We observed patients being referred to appropriate specialities.