Deputy Editor Charlie O’Keeffe reports on urgent improvements needed in Birmingham A&E departments

Written by Charlie O'Keeffe

Following their investigation, Care Quality Commission (CQC) inspectors have reported safeguarding and staffing issues in multiple A&E departments across Birmingham.

The visits were unannounced and brought on by whistle-blowers. Concerns had been raised by the University Hospitals Birmingham NHS Trust. The trust is responsible for the Heartlands, Good Hope, Solihull, and Queen Elizabeth (QE) hospital. With the latter being the hospital closest to our University campus, the QE urgent and emergency care services received a rating of ‘requires improvement.’

The inspectors found that people were not always being protected from harm, as there were concerns about the emergency departments’ safeguarding practices. This included even legally required training. In addition, the inspection revealed that the trust has not been complying with the Accessible Information Standard. This standard requires providing accessible information to individuals with disabilities or sensory loss.

The inspectors found that people were not always being protected from harm, as there were concerns about the emergency departments’ safeguarding practices

It was reported that the services were not managing medicine well. Furthermore, people were not always able to access necessary services, and, when they could, they were not able to receive the correct care quickly.

Additionally, the inspections have revealed that, in addition to the issues patients had met with, the staff were facing problems in the hospitals. The governance systems were not always effective. There had been a series of investigations which found that there were issues with bullying and a ‘toxic culture’ at work which were then impacting the care that patients were receiving. Staff have not always felt respected and supported in the workplace. 

However, the report did highlight positive aspects of staff behaviour, particularly their emotional support. The staff reportedly offered reassurance to patients, families, and carers, and have aided people in understanding their conditions and taking decisions around their treatment. The inspectors even found that, at Heartlands A&E, the more supportive and inclusive staff culture had helped to make improvements to the hospital.

Richard Burden, chair of watchdog Birmingham Healthwatch, said that ‘Learning from and extending this positive culture across the whole trust must now be an immediate priority.’

The inspection was thorough, and occurred in April, May, and June last year, though the report has only just been issued. It involved interviews with 66 patients, 167 staff members, and 20 relatives and carers, and included a review of 75 case records. In the time since these inspections took place, CQC had also carried out an inspection of the trust and an inspection focused on critical care services. The results of this will be published separately.

Jonathan Brotherton, UHB’s Chief Executive Officer, has said in response to the report: ‘We fully acknowledge and recognise that we do not always get things right and there are areas where we need to improve. However, I am confident that since the CQC visited us last year, we have begun to take focussed and positive action by delivering a series of improvements and measures, to support making our organisation the best possible place to be treated and best possible place to work.’

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