Southport and Formby District General Hospital

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• 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

We assessed 1 quality statement from this key question. This assessment did not cover all parts of our Single Assessment Framework; therefore, the key question of responsive remains unrated. Staff were aware of how they could make reasonable adjustments for patients. Leaders and staff were alert to discrimination and inequality that could disadvantage certain groups of people. The service learned and made improvements on feedback from complaints. However, during the assessment we found a breach of regulation for safe care and treatment. This was because patients were experiencing long stays in ED and their planned medical care was not being reviewed daily by a doctor.

This service scored 7 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Person-centred Care during this assessment. There is no previous rating for the Responsive key question so we cannot yet publish a score for this area.

We did not look at Care provision, Integration and continuity during this assessment. There is no previous rating for the Responsive key question so we cannot yet publish a score for this area.

We did not look at Providing Information during this assessment. There is no previous rating for the Responsive key question so we cannot yet publish a score for this area.

We did not look at Listening to and involving people during this assessment. There is no previous rating for the Responsive key question so we cannot yet publish a score for this area.

Healthwatch reviews referred to patients being cared for on the ED corridor for prolonged periods of time waiting for ward beds, with some saying they had spent up to 2 days in the department. Patients told us they had been waiting lengthy periods of time for speciality reviews.

Leaders and staff told us that there were prolonged delays for speciality reviews, particularly for urology and general surgery. Review compliance within the 14 hr standard by a general medicine consultants was 100% at the time of the November 2023 audit. There was a rota for ED reviews taken from the medicine medical rota identifying the locum consultant and locum middle grade assigned to the long waiter team. This team were allocated to ED to review medical patients once the patient had received their post take review. There were 10 patients on the list for the team during the assessment visit, who had already had a post take review, and remained in ED for this team to carry out further ongoing review. The trust had communications in place to discuss challenges with partners. Some plans were in place for change to be made in the future regarding handover and delayed admission management. Patient flow and senior clinicians were supporting clinical teams with a consultant working in the community and on advanced health for care home scheme. Leaders told us that monthly meetings were in place with several partners focusing on Mental Health patients and to improve services and ‘Right Care, Right Person.’ Monthly meetings were also in place with internal stakeholders working to improve direct access pathways. Staff told us that there was a lot of support and resources for people with disabilities and communication needs.

We were informed that following post take ward round (PTWR), all patients in ED fell under the care of the medical long stay patient teams. A list of long stay patients was provided each day and given to the long stay team. On the day of assessment a consultant and a “middle grade/SAS Doctor” were covering these medical patients. Surgical and orthopaedic patients sat under the on call teams. There was no long stay team to see every patient over the weekend, in line with the level of care on the wards, any concerns would, in this case be escalated to the on call team. Should a patient acutely deteriorate and the inpatient team were not available, then the ED team would review irrespective of the clinical team under which the patient sat. We saw length of wait over 12 hours in the emergency department (ED) was 22.1% at the time of assessment. Patients with length of stay in ED between 0 and 2 days was 12.9% with 31.4% staying over 6 days. We saw length of wait over 12 hours in the emergency department (ED) was 22.1% at the time of assessment. Patients with length of stay in ED between 0 and 2 days was 12.9% with 31.4% staying over 6 days. The percentage of patients not triaged within 15 minutes of arrival to the department was 41.8% in March 2024. Emergency ambulance handovers received within 15 minutes from arrival was 25.5% with 52.4% undertaken within 30 minutes of arrival. Ambulance handover delays over 60 minutes was 28.3% of all handovers. T There was a risk that patients attending the emergency department with mental health presentations, and who required admission to a mental health bed. There was a risk of a prolonged stay, and reduced observations caused by a lack of mental health beds in the surrounding area, and a lack of trained mental health nurses in the ED, as stated on the trusts risk assessment.

We did not look at Equity in experiences and outcomes during this assessment. There is no previous rating for the Responsive key question so we cannot yet publish a score for this area.

We did not look at Planning for the future during this assessment. There is no previous rating for the Responsive key question so we cannot yet publish a score for this area.