Wakefield emergency care services under 'sustained pressure' as regulator called for improvements to be made

The Care Quality Commission (CQC) found NHS staff are working under “sustained pressure” following a series of inspections of services across West Yorkshire.

The report also found people experienced difficulties accessing urgent and emergency care.

Inspections took place between March and May this year across West Yorkshire’s integrated care system.

Integrated care boards (ICBs) have been formed across the country to coordinate services and are replacing clinical commissioning groups (CCGs).

The 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.

The CQC also inspected mental health services run by South West Yorkshire Partnership NHS Foundation Trust, GP surgeries, urgent care out of hours services and adult social care providers.

A full inspection of The Mid Yorkshire Hospitals NHS Trust was also carried out. The full findings of that inspection are yet to be published.

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.

“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.”

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The CQC inspectors found:

- Some staff and patients reported difficulties with providing and accessing telephone appointments in GP practices. Some of the issues were due to ineffective telephone systems.

- Yorkshire Ambulance Service NHS was “below target” for response times. It now has an improvement plan in place.

- 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.

- Staffing and capacity issues in both care homes and domiciliary social care services have impacted on timely and safe discharge from hospital.

In response to the inspection Dr Adam Sheppard, Chair of West Yorkshire Urgent and Emergency Care Board said: “It has been helpful to work with the CQC on their new approach to inspecting organisations in a system.

“Their reflections on areas of good practice and good relationships with coordinated action are reassuring.

“It is also notable that they highlight consistent pressure, staffing and social care capacity as issues in West Yorkshire, as these feature consistently in most areas across the country as challenges that need to be addressed.

“We are acutely aware of the challenges faced by our staff and by local people and are absolutely committed to working together across the whole of the system to better join up care and to deliver safe care for all.

“Our staff, volunteers and carers continue to work exceptionally hard, and they should be applauded.

“We will be putting together further actions to prioritise where we can improve following this substantial process.”