Derriford Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We reviewed the delivering evidence-based care and treatment quality statement for the effective key question. Patient risks were not always identified in a timely manner such as screening for sepsis within 1 hour of arrival. Monitoring of risks was not always effective with delays in patients being triaged, screened or treated. Patients were not always kept informed of what was happening. There was a lack of privacy and dignity in some overcrowded areas.

This service scored 50 (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 Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

We observed patients being held in ambulances for long periods due to department being full and appropriate clinical observations were not always carried out. Patients were clinically prioritised to be brought into the department for triage. We observed patients being treated with kindness by staff.

Leaders described work being carried out to improve triage capability depending on staffing. The service used recognised national systems and tools to triage patients. Staff told us how busy the department was on a continued basis and how challenges with the flow of patients could hinder ability to provide effective and safe care. We reviewed electronic patient records and found these were detailed and complete.

There was no effective initial streaming of walk-in patients on arrival at reception, however, children were redirected to the children’s emergency entrance. There was no streaming nurse at reception which contributed to the high numbers of people attending the department. However, there were processes to stream patients at the point of triage. There was no effective clinical oversight of patients waiting to be triaged in the waiting room. A Health Care Assistant (HCA) observed patients in the waiting room but only if capacity allowed. The layout of the waiting room meant that visibility to observe potentially deteriorating patients from reception or treatment rooms was limited. Crowding and noise levels reduced the ability to effectively monitor patients. One specialty, medical care, had doctors based in the department to provide immediate care. However, due to workload there were still some long waits to attend patients.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.