Milton Keynes Hospital

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We rated caring as good. We assessed 2 quality statements. People were treated with kindness, empathy and compassion. Their privacy and dignity were respected. Staff responded to people’s immediate needs. Patients did comment episodes of care could feel rushed at peak times.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We spoke with 7 patients, and all were positive about the care they received within ED. Patients said staff were busy and doing the best they could. We observed patients being treated with dignity and having their privacy respected. Patients did comment that episodes of care could feel rushed at peak times. The ED Friends and Family Test data for April 2023 to March 2024 showed people consistently rated their experience as either very good or good.

Staff could describe examples where they and their colleagues were able to treat patients with compassion, dignity, and respect.

We received mixed feedback from partners. For example, a visiting healthcare professional had observed instances where they felt ED staff lacked compassion towards patients who frequently attended due to self-harm behaviours. However, a mental health partner described that ED staff were responsive to joint working and kind and compassionate towards patients attending with mental health concerns.

Staff were observed demonstrating respect for people’s privacy and dignity, and treating people with kindness, empathy and compassion. For example, we observed a patient being transferred from an ambulance stretcher to a hospital bed. This was completed with dignity and care, utilising privacy screens. We observed various handover meetings where staff routinely referred to the psychological and emotional needs of patients. Nursing and medical staff were observed treating non-English speaking patients with dignity and empathy. Nursing staff were observed communicating procedures clearly to patients, gaining consent and had a kind manner. ED staff arranged a private entrance to uphold the dignity of a patient who attended ED from a local secure unit. Upon arrival, the patient was warmly welcomed by staff and a senior nurse was assigned to provide consistent care throughout their journey in the ED. The patient was offered refreshments and engaged in conversation. Nursing staff triaged patients attending with mental health concerns in a kind and engaging manner. They assessed patient presentation and guided them to a more suitable waiting area. Staff would use private spaces where possible for those that displayed concerning behaviours that might impact on others.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

We saw staff responding to people’s immediate needs on inspection. Data submitted by the trust showed the service was working to reduce time to treatment through all admissions into the hospital. When patients communicated their needs, emotions or distress, staff could manage this in a way that protected the patient’s rights and dignity. The department undertook audits to monitor pain relief. As part of the audit, patients were asked whether staff had asked them about their pain and whether they had experienced any wait to receive pain relief. Audit results showed that patients had consistently scored staff highly in these metrics. The trust carried out in April 2024, a Care and Comfort Rounds Audit for the ED - to check the care they gave to the patients and to ensure it was recorded. Comfort rounding includes a review of positioning, pain and personal needs. The audit found 26% of patients had no comfort rounds documented. Leaders produced an action plan for audits going forward.

Leaders had developed the availability of same day emergency care services to improve access and flow within the hospital. Leaders had focused on improving timeliness of ambulance handovers and long waits within the emergency department. At the time of the assessment, staff stated work was ongoing to implement electronic mental health risk assessments. Staff said they generally were able to tend to patients’ needs however this was not always possible when the department was busy.

Security guards confidently addressed inappropriate behaviour, used de-escalation techniques and listening and communication skills to engage with patients struggling with mental health issues and other challenging behaviour. Patients on were offered food and drinks.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.