Huddersfield 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 good. At this assessment the rating has remained good.

This meant people’s needs were met through good organisation and delivery.

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.

We have not awarded this service a score for Responsive.

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

The service did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

We found staff were not consistently asking patients about pain at initial assessment or during subsequent checks. This led to delays in recognising patients who required pain relief and contributed to avoidable delays in medication administration. Staff informed inspectors that they held Patient Group Directions (PGDs) enabling them to supply or administer paracetamol, ibuprofen and codeine phosphate. However, during observations, no analgesia was offered or administered to patients, even when pain was identified during triage. There was a noticeable lack of pain assessments, and where pain was identified, appropriate analgesia was not provided.

In the CQC UEC Survey 2024 in response to the question “Do you think the hospital staff helped you to control your pain” the department scored below the national average.

Staff knew how to contact the dementia care specialist nurse for support. However, time limitations meant staff were not always able to take meaningful action to support individual needs. Patients living with dementia should ideally be placed in high visibility calm areas to enable good oversight of their needs. However, during our assessment, we saw patients with dementia placed in escalation areas, this did not meet their needs.

The environment of the paediatric ED was well designed for younger children who could watch programmes on the television in the waiting area. Soft seating areas meant they could move around easily without risk of injury. There were ample play resources. There was water and juice available for children and parents, although there was no dedicated waiting area for older children and teenagers.

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.

The ED team engaged with other healthcare providers both within and external to the hospital to ensure that patients received appropriate follow-up care.

All patients attending the department were registered on the patient records system and staff completed the documentation of hospital handover using an electronic system.

External partners, such as GPs, community nurses, and social workers were involved to enable continuity of care and support for discharge. The department had formal agreements with other NHS Trusts and tertiary centres to facilitate transfers of care where required.

Staff could give examples of patients who had varying levels of need and could describe how they would accommodate them.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people. We were told how staff could refer or redirect patients to other services such as, maternity, palliative care, charitable organisations and social care.

The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Patient information leaflets were available on the trust’s ED clinical guidance platform. The department had posters with digital codes on for people to scan with their phones to access health information. However, we did not see evidence of how patients who may not be digitally literate, may have a learning disability or may not have the means to access digital information could access these resources in a comparable way. We did not see printed information leaflets in patient areas.

Staff had use of an interpreting and translation service, which provided access to on demand and prebooked 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 and staff, which is not in line with current guidance.

The waiting room had a board on which waiting times were electronically displayed and this was updated regularly.

We observed appropriate conversations between medical staff, patients and family members about treatment plans and options. We saw there was a private family room where staff could take families and carers, when delivering bad news.

Staff informed patients about alternative support available to them and referred patients to external support services such as for mental health support and support for young adults and their parents and carers.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

We saw complaints information in the UEC department, for example “Feedback Matters” posters were displayed on toilet doors, the QR code was functional and directed patients to the feedback form. We also saw paper feedback forms in the department.

Patients and families were supported to raise their concerns with the department. In the first instance this was to escalate to staff and leadership team. If they were unable to provide a resolution, patients were signposted to the Patient Advice Liaison Service.

Staff understood the policy on complaints and knew how to handle them. Managers investigated complaints and identified themes.

Patients told us they knew how to make a complaint or raise a concern and when they had raised concerns these had been addressed promptly.

Complaints were investigated by senior leaders within the service. Managers shared complaints, compliments and any learning with all staff through face-to-face meetings, newsletters and emails.

The service took part in the urgent and emergency care survey 2024, a patient experience survey conducted by the Care Quality Commission (CQC) in England. Its aim was to assess patient experiences in UEC departments including wait times, communication, and overall quality of care. The service performed the same as the England average for 25 questions and “worse than expected” for two questions, which were around getting help whilst waiting and medication information. This survey was carried out when the area was still part of the previous UEC department.

The service made sure that people could access the care, support and treatment they needed when they needed it.

Data we reviewed showed that between April 2025 and December 2025, the proportion of patients who left the UEC department before being seen ranged from 3%- 4%. This was better than the England average of 5% nationally.

Between April 2025 and December 2025, reattendance rate within 7 days of previous attendance ranged between 7%- 8%, this was consistently lower than the England average, 9% nationally.

We saw that in the 6 months preceding inspection, 99% of all patients who presented with mental ill health were seen within one hour of referral.

We found 2% of patients waited over 60 mins for ambulance handover which was better than the national average.

Time to initial assessment for emergency ambulance was 8 minutes and consistently better than the national average of 10 minutes.

We saw that 83% of patients were seen within 4 hours of arrival, compared to 60% nationally.

Patients waiting more than 4 hours since March 25 was 24%, which was better than the national average.

An average of 10 patients per month waited more than 12 hours for admission which was consistently better than the national average.

We found that access to X‑ray for children supported equity in access and reduced unnecessary movement through the department. Staff told us they could contact the radiographer directly when imaging was required, and the radiographer attended the paediatric area promptly.

Children did not need to leave the corridor or be transferred through adult areas, as radiographers came to them wherever possible. This arrangement minimised disruption, reduced exposure to busier parts of the department, and ensured that children—particularly younger or more vulnerable patients—received diagnostics in a safe and appropriate environment.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff within the service and the wider organisation understood and could give examples of people who were most likely to experience inequality in experience or outcomes within their community.

Staff worked hard to remove any barriers to access for patients. Staff listened to people who had concerns or complaints and sought ways to improve the service.

Staff actively signposted patients and carers to additional services, including community pharmacies and dentists. This meant patients and carers could have access to timely support beyond the department, helping them to manage their needs more effectively and reducing unnecessary pressure on urgent and emergency care services.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

All staff we spoke to praised the work of the BLOSM team which was a trauma-informed support service embedded within the UEC departments at Huddersfield Royal Infirmary and Calderdale Royal Hospital, which focused on addressing health inequalities and unmet non-medical needs in ED. They provided ED staff with clear guidance to support vulnerable patients.

Staff were trained in equality, diversity, inclusion, and human rights, with overall staffing at 91% compliance, although medical staff were only 77% compliant.

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.

Staff had access to the trust wide resuscitation policy and ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) documentation.

The ReSPECT process created personalised recommendations for a person’s clinical care and treatment in a future emergency in which they are unable to make or express choices. These recommendations were created through conversations between a person, their families, and their health and care professionals to understand what mattered to them and what was realistic in terms of their care and treatment.

Staff were able to clearly explain how they supported people who were nearing the end of their life. They described how they ensured care was delivered in a sensitive and dignified way, and this was consistent with the good practice we observed.

We were told there was also a ReSPECT standard operating procedure, as well as training and guidance videos available for staff.

We reviewed DNACPRs forms during our assessment and these had mostly been completed correctly.

Since October 2025, a multi‑agency group had been established to improve the experience of carers during the discharge process. Membership included carers, people with lived experience, and staff from health and social care services.

However, whilst 100% of nurses had completed end of life care level 2 training, only 61% medical staff were compliant. Nurses were 92% compliant for level 3.