Inspectors warn of safety concerns at Doncaster hospital emergency department

Concerns have been raised over levels of safety at the emergency department at Doncaster Royal Infirmary by Government inspectors

The Care Quality Commission carried out ‘focused’ inspections at Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust’s urgent and emergency services.

Ambulances parked outside Doncaster Royal Infirmary's emergency department

Ambulances parked outside Doncaster Royal Infirmary's emergency department

They raised concerns about assessments and observations being done by unqualified staff, that had little or no training, although systems and processes have been put in place to ensure improvements in relation to safety in Doncaster.

Concerns were also raised about a reliance on locum consultant doctors,and patients  not being observed thoroughly by experienced staff, which risked any deterioration not being treated promptly. Both hospitals were not identifying or recording risks well. 

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The CQC carried out the inspections at both Doncaster Royal Infirmary and Bassetlaw District General Hospital between 27 and 29 November 2018, looking specifically at the urgent and emergency services. The inspections were prompted by the CQC’s previous findings at the full inspection of Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust in December 2017.

At Doncaster Royal Infirmary, the category of ‘safe’ was rated inadequate and ‘caring’ was rated good. Effective, responsive and well-led were rated as requiring improvement, and the hospital’s service was rated requiring improvement overall.

Urgent and emergency services at Bassetlaw District Hospital were rated requires improvement overall. Safe, effective and well-led were also rated requires improvement, while caring and responsive were rated good.

The trust’s overall rating of requires improvement is unchanged.

CQC’s Deputy Chief Inspector of Hospitals, Ellen Armistead, said: “We saw that staffing remained an issue across both hospitals, particularly paediatric nurse staffing. There was a reliance on locum consultant doctors at Bassetlaw, and at Doncaster we had concerns that patients were not being observed thoroughly by experienced staff, which risked any deterioration not being treated promptly. Both hospitals were not identifying or recording risks well. 

“We did see some encouraging improvements at Bassetlaw, and work was being done to address our recent findings, there are concerns which have gone unchallenged. We did see that staff at Bassetlaw District Infirmary were very caring and provided patients with appropriate emotional support. 

“At Doncaster Royal Infirmary, to address concerns regarding initial assessments of patients arriving at the urgent and emergency service, inspectors were concerned that the assessments and observations were being done by unqualified staff, that had little or no training. I am encouraged that trust have put in systems and processes to ensure improvements in relation to safety in Doncaster.

“However, the hospital’s staff were seen to be caring and offering patients with an appropriate level of emotional support. Staff were good at keeping patients involved in their care decisions and informed them of any progress made. The service was working well to ensure patients were seen in a timely matter, and escalated appropriately.

 “We will continue keep the trust under review and return to inspect it again in due course, and report on our findings.”

The trust has been approached for comment.