Our revisit to the Adults Emergency Department at Leicester Royal Infirmary finds welcome changes and we recommend continuing with improvement work.
In September 2022, Healthwatch Leicester, Healthwatch Leicestershire and Healthwatch Rutland visited the Leicester Royal Infirmary (LRI) Adults Emergency Department (ED) to observe the department and listen to patient experiences. These findings were presented to the University Hospitals of Leicester NHS Trust (UHL) to assist them with improving the patient experience at ED.
In September 2023, Healthwatch revisited this project and further engaged with people in the ED. The revisit uses the 16 recommendations from the 2022 report as a framework for assessing changes that have been made to improve patient experience over the year since the original visit.
Healthwatch acknowledges the UHL response to the 2022 report and the huge amount of work carried out across Leicester, Leicestershire and Rutland to improve patient flows. We also recognise that ED is an area where patient demand can often exceed resources. With this in mind, and following our revisit, we recommend continuing with improvement works with a particular focus on the following:
- Continue to explore options for people who may need to lie down whilst waiting for assessment.
- Consider using screens that are not in use to display information for patients such as waiting times, complaints procedure, carers’ charter and data privacy.
- Find a system for calling patients into assessment or treatment areas which is straightforward, does not introduce excessive background noise and is appropriate for those people with hearing or sight problems.
- Establish a procedure for those patients who have to temporarily leave the waiting areas, so they do not lose their place in the queue.
- Remove the unused porta cabin outside ED to provide easier access for people with additional needs and those who use wheelchairs.
- Consider displaying posters and information in other languages.
- Review the appropriateness of giving diagnoses and test results in the waiting room in the presence of other patients.
- Ensure consistent assistance and observation of patients in the waiting room for signs of deterioration.
- Display clear information for patients about how they can alert staff to their worsening signs and symptoms of illness or injury.
- Position portable warning signs where they do not present a tripping hazard.
Harsha Kotecha, Chair, Healthwatch Leicester and Healthwatch Leicestershire said,
“We welcome the ongoing commitment from UHL to listen to the feedback from patients. Our recommendations aim to address observations and comments from patients during our visit to assist UHL in improving the emergency department services.”
Dr Janet Underwood, Chair, Healthwatch Rutland said,
“The changes that UHL have made since our 2022 visit to ED and their action plan in response to this 2023 visit are extremely encouraging and demonstrate a commitment to continual improvements. We thank UHL for their co-operation and wish them every success in addressing the remaining points we have raised to improve patient experience of the service.”
Richard Mitchell, Chief Executive, University Hospitals of Leicester NHS Trust said:
“We appreciate recommendations for how we can improve the way we deliver care, and as a result have undertaken work to improve patients’ experience of our Emergency Department. This includes updating and expanding the range of information on display screens, and ensuring dedicated staff are providing consistent observation of patients in the waiting area for signs of deterioration. Work is underway to look at removing the portacabin to improve access, and we are developing ways to both improve the way patients are called and reduce background noise in reception areas. Our Patient Experience team is exploring ways in which we can provide information in other languages, and our cleaning teams are reviewing how they position portable warning signs to avoid creating a trip hazard.
“We would like to thank all patients and visitors to the Emergency Department for their patience and understanding, and apologise to anyone who has experienced a long wait over the busy winter months.”
The UHL action plan showing progress updates on the Healthwatch recommendations is detailed in the full report.