The Care Quality Commission (CQC) has found improvements are needed to ease pressure on urgent and emergency care services across West Yorkshire, which includes Wakefield, Bradford, Dewsbury, Airedale and Leeds. This follows a series of coordinated inspections which took place from March to May, across the West Yorkshire integrated care system.
Integrated care systems (ICSs) are new partnerships between organisations involved in health and care across an area. Integrated care boards (ICBs) have been formed across the country to coordinate services to improve people’s health and care and are replacing clinical commissioning groups (CCGs).
These inspections were conducted to understand how services respond to the challenges they face as individual providers but may require a system wide response to improve patient care. They are also intended to support ICBs to better understand the journey people experience when using urgent care services and identify where they can make improvements. To read more about this work visit the CQC website.
During these inspections, CQC found services were under continued pressure and people experienced difficulties accessing urgent and emergency care. Leaders across West Yorkshire were working together to find opportunities to improve people’s experiences when using these services.
As part of the review across the West Yorkshire integrated care system, CQC inspected 999 and NHS 111 services run by the Yorkshire Ambulance Service NHS Trust, as well as urgent and emergency care run by The Mid Yorkshire Hospitals NHS Trust and Bradford Teaching Hospitals NHS Foundation Trust.
CQC also inspected mental health services run by South West Yorkshire Partnership NHS Foundation Trust, local GP surgeries, urgent care out of hours services and adult social care providers. (Links to these services can be found at the end of this press release.)
CQC also carried out a full comprehensive inspection at The Mid Yorkshire Hospitals NHS Trust, and the full findings for this trust will be published on the website in due course.
Ann Ford, CQC director of operations network, said:
“During the urgent and emergency care inspections across West Yorkshire, staff were working hard under sustained pressure. It was reassuring that leaders were working together to support their workforce and to identify opportunities where improvements could be made, however people continued to experience delays in accessing care and treatment.
“We found people’s experiences of emergency departments were varied depending on which service they accessed. Some had long delays, while others performed relatively well. In services struggling to meet demand, patient flow was an issue. This was mainly caused by delays in discharge, due to people being unable to access community or social care services which must be addressed as a matter of priority. This is being addressed by the ICS as a matter of urgency with a partnership wide working group across all sectors.
“The NHS 111 service was experiencing significant staffing challenges and were in the process of recruiting new staff. Also, this service had experienced an increase in demand, particularly from people trying to access dental treatment, although a system was in place to manage the need for dental advice and assessment.
“Across West Yorkshire, it’s important that service leaders continue to work together to improve patient pathways across urgent and emergency care, to alleviate pressure on other services and ensure people receive the best possible care.”
Across the system, inspectors found:
- Some staff and patients reported difficulties with providing and accessing telephone appointments in GP practices. Some of these issues were due to ineffective telephone systems which were being looked at to try and resolve the issues.
- The ambulance service had an improvement programme in place focused on performance and staffing. While there was some improvement in ambulance response times and handover delays, performance remained below target.
- Mental health services in Wakefield were delivering person-centred care and responded to urgent needs in a timely way.
- Staff working in some social care services reported significant challenges in relation to hospital discharge processes, this included a lack of information to support their transfer of care and we were told of examples when this resulted in people having to return to hospital. Local stakeholders had a good understanding of this problem and were looking to improve pathways and discharge planning.
- Staffing and capacity issues in both care homes and domiciliary social care services have sometimes impacted on timely and safe discharge from hospital.
- There were inconsistencies with triage processes in primary care which could result in people being inappropriately signposted to urgent and emergency care services. However, a number of staff working in social care services reported good engagement with local GPs.
GP surgeries
- Woodside Surgery
- The Grange Group Practice
- The Avicenna Medical Practice
- Dr Ishtiaq Gilkar
- Ash Grove Medical Centre
- The Grange Medical Centre
- The Arthington Medical Centre
- Bilton Medical Centre
Urgent care out of hours service
- Sheridan Teal House
- King Street Health Centre (walk-in centre)
- Walk-in Centre (Locala Community Partnerships C.I.C)
Care services
Embargoed versions of these reports can be found at the end of this press release.
Hospitals
Mental health
Ambulance service