Peterborough City Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We rated responsive as requires improvement. We assessed 3 quality statements. People received person-centred care with support from other services to provide integrated care. Staff were overall caring and attentive to patients including during busy periods. We encountered concern about problems of flow of patients through the hospital which impacted on the department and the need to improve response times when patients had been referred to other specialities. People did not always access care, treatment and support in a timely manner. People did not experience discrimination and staff worked to provide equity in access to care and treatment.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The patients we spoke with were overall positive about the care they were receiving despite the wait they experienced sometimes.

Patients’ care plans contained information about their physical, mental, emotional and social needs. Staff on the U&EC service told us they had access to the Learning Disability (LD) team. The LD team provided support to staff on the U&EC service to carry out capacity and decision specific assessments. Staff told us they completed the assessments electronically, and the LD team could then review these to make sure they were acceptable.

Staff we spoke with were aware of the need to undertake risk assessments, how to undertake them and who to contact for support. Also, the need to respect patient’s wishes.

Staff were overall caring and attentive to patients needs even though they were very busy. Staff were also polite, approachable and friendly.

Patients had their nutrition and hydration needs checked on a regular basis, but this was challenging when caring for patients in the corridor at times of increased demand. We did observe a mental health patient whose needs were met for food and hydration after an initial delay.

Staff working in U&EC said that they felt part of a team. Staff were overall flexible although there were some challenges to this in the paediatric ED due to the specific skills and experience required. It was challenging at times to ensure there were sufficient paediatric trained, competent nurses on duty.

Many staff told us there were problems with the flow of patients through the hospital which had an impact on the ability of the U&EC department to manage the high numbers of patients within the service. We were told by leaders about partnership working with the medical and surgical divisions to improve flow, reduce overcrowding and reduce length of stay in U&EC.

Leaders told us that they met with community partners on a regular basis and engaged with the Integrated Care Board about patient flow and pressures on the U&EC department and how integrated working could assist with this.

The hospital service executive management team had started a comprehensive programme of workstreams to improve engagement and motivation of staff and build relationships with system providers. The aim was to improve the U&EC and patient flow pathway. One of the workstreams aims was to improve patient flow, decision-making and safe patient care by adhering to interprofessional standards (IPS) when referring patients according to agreed criteria. We were told that the process data did broadly show that there was room for improvement with IPS response times across several specialities in the hospital. Some specialities consistently reported a low response rate to referral from U&EC within 60 minutes for example, the psychiatric liaison team, medical teams, trauma and orthopaedic teams. These were key services for many patients that presented to U&EC and would impact on patient flow from U&EC services to other services.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People did not always access care, treatment, and support in a timely manner including out of hours and in an emergency. People did not experience discrimination or inequality. People with additional needs did not feel they were disadvantaged. The service made reasonable adjustments for people with disabilities. For example, a patient with a hearing disability was communicated with in a compassionate and caring manner.

Staff worked hard to remove barriers to access for patients. Leaders informed us that they listened to patients who had concerns or complaints and sought ways to improve the service. However, adults and children and young people did not always receive care, treatment and support in a timely way. Leaders had been working on redesigning the patient pathway to improve access to urgent care in a timely manner by carrying out an initial clinical assessment when patients arrive at the U&EC reception. This had only relatively recently been introduced at the time of the assessment and needed further evaluation by the U&EC leadership team.

The U&EC service was open 24 hours a day, 7 days a week. Adults and children and young people were cared for including those seeking treatment for mental ill health. The service worked with other healthcare professionals to provide a comprehensive service for different healthcare needs and serious conditions needing specialist input. However, there was inconsistency in the response and access to mental health specialists. In July 2024, 79% of mental health patients were responded to within 1 hour of referral from the U&EC service. The psychiatric liaison team had low staffing levels on occasions which could contribute to a delay in response to referrals from the U&EC service.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.