Royal Cornwall Hospital

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We reviewed the delivering evidence-based care and treatment quality statement for the effective key question. Patients were kept informed of what was happening and were offered something to eat and drink if they had been in the department for a long time. The service carried out regular audits, including monitoring against the emergency care standards however, during the period December to February the ‘fundamentals of care’ audits were not carried out. This audit measured quality indicators such as whether the skin bundle forms had been completed within 4 hours to determine the level of pressure ulcer risk. Regular auditing helps to drive service improvements.

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.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

Patients said they had been offered something to eat and drink. One patient was being assessed for the possible need for surgery and had been indicated as ‘nil by mouth’ to avoid surgical complications. This patient was aware of this and said it was being adhered to by staff and it had been explained well. Those patients we met who had been in the department for a long time said they had been given a sandwich and a hot drink so far, and two patients said they had tea and toast for breakfast.

The emergency department, like many departments nationally, struggled to meet best practice guidance and standards. Patient risks were not always identified in a timely manner such as screening for sepsis within 1 hour of arrival. In April 2024, data showed 72% of patients who met the criteria received antibiotics within an hour against a national target of 90%. This however was an improvement since the last inspection where we saw compliance against this target at around 50%. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure and death. The department had a lead for sepsis and staff were able to talk through the arrangements for sepsis management in detail.

There were processes to monitor performance against evidence-based good practice and standards. The service had effective processes to direct patients to other departments and organisations to try and avoid patients who do not require emergency care or where the emergency department was not the most suitable environment for that person, turning up at the emergency department. For example, the service had community assessment and treatment units, frailty services and same day medical and surgical units.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.