New Royal Liverpool University

Ratings - Urgent and emergency services

• Overall

  Good

• Safe

  Good

• Effective

  Good

• Caring

  Good

• Responsive

  Requires improvement

• Well-led

  Good

Our view of the service

We carried out an unannounced assessment of New Royal Liverpool University on 10 and 11 December 2024. We carried out this assessment in line with our assessment priorities as part of our well led assessment. We assessed the following service groups:

• Urgent and emergency care

Overall, the service was rated as good. We conducted an on-site, assessment visit at New Royal Liverpool University Hospital Urgent and Emergency Care Services and reviewed access, flow, and care of patients in the temporary escalation areas. We assessed all the quality statements from the safe, effective, caring, responsive and well-led key questions. The service provided and maintained safe systems of care, in which safety was managed, monitored, and assured. The service was previously rated as inadequate in 2021 and it is now rated as good. It was last partially inspected to follow up on previous enforcement action in September 2023, but it was not rated at that time. We looked at 10 sets of patient clinical records; we spoke with 8 patients; we spoke with 8 family members or friends; and we spoke with 16 members of staff. We assessed quality statements within key questions. Each quality statement assessed is awarded a score.

Areas for improvement

Action we have taken:

We found the following breaches of regulation.

The provider must:

• Continue to improve flow through the department working with the other divisions to achieve this along with other health and care providers.
• Continue to implement an adequate system of internal control and improvement in practices to ensure infection, prevention and control improves.

People's experience of this service

People using the service told us: Patients, their family, and carers were positive about interaction with staff and the treatment they received in the emergency department. All said they were treated with compassion and kindness. All patients’ felt communication was good and that they were informed of care options and treatment plans. Patients and their families felt there was adequate and visible staff in the department, and that it was clean and tidy. Many said they were treated with privacy and dignity, however when patients were waiting in areas not designed for clinical care (temporary escalation spaces), they experienced difficulties maintaining confidentiality as conversations with staff could be overheard. On arrival at the emergency department patients who had walked in were assessed quickly but they reported long waits for a bed when admission was required. Patients arriving at the department by ambulance experienced delays in their care being transferred to hospital staff. Patients also raised concerns about the environment not being suitable in temporary escalation areas due to the noise, people walking by and lack of access to bathrooms. People said they knew how to raise concerns.