Huddersfield Royal Infirmary

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

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people were supported and involved as partners in their care.

We looked for evidence that people were always treated with kindness, empathy and compassion. We 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.

We identified a breach of regulation, we saw vulnerable patients were cared for in unsuitable and unsafe areas, where privacy and dignity were limited.

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 service did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

During the inspection, we observed that walk‑in patients were initially assessed in one of the two designated triage bays. However, when both bays were occupied, triage activity moved to the nurse’s station, which was situated adjacent to the ambulance handover area. On one occasion, two ambulance handovers occurred simultaneously while a patient triage was taking place. This created a situation where the walk‑in patient was able to overhear confidential clinical information being communicated during the ambulance handover.

Privacy and dignity were not always maintained for patients in the corridor. Patients held in public areas were visible to others passing through, and conversations related to their care could not always be kept confidential. The lack of appropriate clinical space, combined with overcrowding, contributed to an environment where people’s dignity was not always protected and staff could not always provide safe, person‑centred care. We saw people receiving personal care and medical treatment without their privacy or dignity being properly maintained. This was a breach of Regulation 10. However, on the night of the inspection the organisation was operating at high Opel 3. This meant there was high pressure on the department due to how busy it was. The surge and escalation plan had been enacted.

Staff and leaders acknowledged the difficulties in ensuring that dignified care was always upheld for patients in the corridor areas and acknowledged the extended time other patients waited for treatment. Staff gave examples of how they understood and respected the individual needs of each patient. Staff told us that working relationships within the UEC department were positive.

Patients told us they felt reassured by the staff and were confident in their care. Feedback obtained from patients during the inspection was consistently positive. Patients spoken to reported that they felt safe while using the service and raised no concerns regarding the care they received. Patients described staff as supportive and expressed confidence in the standards of treatment provided.

Staff were discreet and responsive when caring for patients. Staff took time to interact with patients and those close to them in a respectful and considerate way. We observed kind, caring interactions between patients and staff. Staff explained to patients what they were doing when providing care and treatment. Patients said staff treated them well and with kindness.

Chaplaincy staff and facilities were available to support patients, carers, and staff in response to cultural, religious, or unexpected needs such as a death. A relative’s room was available for private conversations. This meant patients, carers, and staff had timely access to emotional, cultural and spiritual support, with private space available for sensitive conversations when needed.

The service did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences.

Staff had use of an interpreting and translation service, which provided access to face to face, video and telephone interpretation services. During inspection we did not see staff make use of this service, instead, staff relied on the use of the patient’s family members. This approach does not follow recommended guidance, such as language interpreting and translation: migrant health guide.

Data provided by the trust showed that between March 2025 and December 2025 66 interpreters were booked.

We communicated with 2 patients whose communication needs had not been met, an individual whose first language was not English and a patient who communicated by British Sign Language. Not meeting communication needs meant there was a risk that patients could not understand or convey important information, leading to unsafe decisions, unmet care needs, and reduced involvement in their own treatment.

Staff told us that patients were offered a choice of meals that met a range of dietary needs, including requirements linked to religious and cultural preferences, as well as food allergies and intolerances. However, we did not observe any mealtimes during the inspection.

The department was very busy, and staff told us it was not always possible to find quiet areas for people who were living with dementia, or who were neurodivergent. They did however tell us that whenever possible patients would be placed in quieter areas including cubicles, if it was safe to do so.

There was no dedicated play specialist based in the children’s UEC department. Staff told us they could request support from the play specialist team on the children’s ward when required. National Play Well guidance states that therapeutic play should be a core part of children’s healthcare and that registered health play specialists should be integrated within multidisciplinary teams to support children during procedures and reduce distress.

The trust ensured the department was easily accessible to people with physical disabilities including those who used wheelchairs and walking aids.

We heard how the trust’s chaplaincy service provided inclusive spiritual, pastoral and religious support to patients, families, carers and staff, regardless of faith or belief. The service also supported cultural understanding through staff engagement and education, such as mosque visits that focused on end-of-life care for Muslim patients.

We were shown care packs for people who, because of their needs, could find waiting in a busy UEC department challenging. They include ear defenders, tactile objects, a colouring book and crayons and an easy read leaflet to support them through tests and investigations while they were in the department.

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

Patients and their families told us they were involved in their care decisions. This included difficult conversations relating to care and treatment. This meant patients and their families were supported to understand their options and felt involved in care decisions, even during difficult conversations, helping them make informed choices about treatment.

Within the paediatric UEC, we witnessed staff supporting children, young people and their families, explaining things in a child-friendly way. They allowed time for questions and reassured all present by making sure people understood the next steps in their care and treatment journey.

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

Staff provided emotional support to patients, families, and carers to minimise their distress. They understood patients' personal, cultural, and religious needs. Staff gave patients and those close to them help, emotional support and advice when they needed it. All contact between staff and patients was conducted professionally, sensitively and in a way which respected the emotional wellbeing of both patients and their relatives and carers.

Staff we spoke with understood the emotional and social impact that a person’s care, treatment, or condition had on their wellbeing and on those close to them. Staff supported and involved patients, families, and carers to understand their condition and make decisions about their care and treatment.

Staff introduced themselves and established a good rapport with their patients. Staff at all levels of seniority across all professions demonstrated caring and attentive attitudes towards patients.

We observed that call bells were answered quickly, and we saw staff interact with patients who were agitated and confused in a calm and caring manner.

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

Staff told us they felt positive and proud about working for the service and their team. Staff had access to support for their own physical and emotional health needs through an occupational health service, to which they could self-refer. They also had access to an employee assistance programme, benefits of this included access to an online GP, 7 days a week.

Staff described a culture where debriefs were routinely offered following challenging events, and these were viewed positively. They reported feeling well supported during and after difficult shifts. Access to the psychology team was available, providing additional emotional and wellbeing support.

The department provided a designated well-being room to enable staff to step away from the clinical environment when needed. This meant staff had access to a quiet space away from the clinical environment, supporting their wellbeing and ability to provide safe, compassionate care.

Staff had regular appraisals with the compliance rate for UEC at 83% for all staff groups. Staff appraisals included conversations about career development and how it could be supported. We were given examples of how staff had been supported with moving into senior roles and with advanced clinical roles.

Staff told us they were regularly exposed to violence and aggression from some patients and visitors. They reported that security staff were not based in the department and that it could take time for security to attend when called. Although security teams undertook regular patrols, they were responsible for the entire hospital site, which contributed to delays in response times during incidents.

Staff in the urgent and emergency care department scored the trust lower than the national average on the NHS Staff Survey 2024 theme “We work flexibly”. This theme reflects how well staff felt they can achieve a good work–life balance and whether they are supported by the organisation to work flexibly. The results showed that staff in this trust felt less supported to balance their work and personal lives than staff nationally.

We reviewed the trust’s response to the survey, including the document “How do we improve our staff survey?”, and saw that the main action proposed in response to the lower flexible‑working score was to ensure annual leave is taken at regular intervals.

The UEC directorate carried out its own internal staff surveys alongside the national staff survey. These local surveys were introduced after the Urgent Same Day Emergency Care pathway was implemented, to understand how the changes were affecting staff experience.