ACTION is being taken by the chief inspector of hospitals to protect the safety of patients in Dudley after an inspection found Russells Hall Hospital’s emergency department to be failing.

Inspectors visited the hospital on June 28 and looked specifically at urgent and emergency care as a result of continued safety concerns surrounding the service.

The inspection found a number of concerns regarding the triage, assessment and tracking of patients in the emergency department, particularly with regard to the management of patients with suspected sepsis.

Inspectors also found care records were not always written and managed in a way that kept patients safe and some staff raised concerns regarding the leadership style of some of the executive team, speaking of a poor culture and working environment.

As a result of the inspection, CQC took action to vary conditions on the trust’s registration, meaning the Dudley Group NHS Foundation Trust, which runs Russells Hall, will have to provide regular updates regarding the concerned areas.

Diane Wake, chief executive of the Dudley Group, welcomed the CQC’s findings, adding the trust is “absolutely determined” to deliver the improvements within its emergency department to ensure patient safety.

Ms Wake said: “Following the June inspection, we made immediate changes to our triage processes, how we identify, escalate and manage patients who present with sepsis or a deteriorating medical condition, and undertook a comprehensive staffing review in line with professional standards and best practice guidance.

“Specifically, we have increased resources during times when the department is at its busiest and can demonstrate week-on-week improvement in triage time. In August, 89.76 per cent of patients were triaged within 15 minutes. Our aim is to triage 95 per cent of patients within 15 minutes.

“We have retrained staff in ED in the screening and management of sepsis and introduced eSpesis to automate the process of identifying and monitoring patients at risk for sepsis. We have also introduced electronic observations along with a comprehensive dashboard that enables us to monitor patients in real-time and retrospectively.

“We have reviewed and agreed the need to increase ED consultant cover by a further five consultants and put in place an additional clinical support worker to support the waiting area.

“The CQC has been frustrated at the pace of change and so we have received external support from an emergency care improvement team. We have also approached a neighbouring trust whose ED was rated ‘good’ by the CQC to share best practice between ED consultants.

“We have recently appointed a new clinical lead for urgent and emergency care who is focused on working with our emergency teams to improve the care we deliver.

“We are moving towards a continuous improvement culture and replicating good practice to provide an outstanding service for our patients.”

The trust has been told it must make the following improvements:

• It must ensure all systems and processes in place to identify and manage patients with deterioration effectively are followed.

• Staff must record an accurate, complete and contemporaneous record of the care provided to patients.

• The trust must ensure there are sufficient numbers of staff, who are suitably trained and competent, to care for the number and acuity of patients.

• Deaths in the service must be reviewed robustly and appropriate lessons from these must be learned and shared.

The full inspection report is available to read by clicking here.

Heidi Smoult, deputy chief inspector of hospitals in the central region, said: “We have had ongoing concerns about the emergency department at Russells Hall Hospital and were extremely concerned at what we found during our inspection.

“Patients were not being consistently assessed in a safe way, in particular, whether staff were identifying patients with suspected sepsis effectively. As a result of this we have varied conditions on the trust’s registration meaning it must provide regular updates to CQC surrounding staffing, triage of patients and its management of sepsis.

“Inspectors returned to the department in August to carry out a further inspection and a full report of this inspection will be published in due course. Meanwhile, we continue to monitor the trust extremely closely.

“We have also continued to escalate our ongoing concerns with partner organisations and to work with NHS Improvement to ensure that necessary steps are taken to improve safety for patients. The trust knows what it must do to ensure people receive the care they should be able to expect and we will return to check on whether sufficient improvements have been made.”

Russells Hall Hospital is currently rated as ‘requires improvement’, but the recent inspection was not rated and does not change the overall rating for the hospital.