THE Chief Inspector for Hospitals has reported further enforcement action is to be taken against the Dudley Group as serious concerns about the trust's emergency department continue.

Inspectors visited Russells Hall Hospital, which is run by the Dudley Group NHS Foundation Trust, in August and looked at urgent and emergency care amid continued safety concerns.

It found numerous concerns and areas of poor practice - following which the CQC has placed a further urgent condition on the trust’s registration.

Professor Ted Baker, Chief Inspector of Hospitals, said: “We remain very concerned about the emergency department at Russells Hall Hospital as a result of our inspection.

“This is why we have imposed an urgent condition on the trust’s registration to safeguard patient safety. This condition relates to the provision of specialist medical provision and support into the emergency department.

“The condition requires the trust to report to CQC on a weekly basis detailing the action it is taking to ensure specialist teams are resourced and have capacity to offer clinical oversight within the emergency department. It must also report back on the outcome of auditing, monitoring and implementing additional clinical support for the department.

“We are monitoring the trust extremely closely and continue to work with NHS Improvement to ensure patient safety improves. We will return to check on whether sufficient improvements have been made and will take further action if needed.”

Russells Hall is currently has a Requires Improvement rating overall but urgent and emergency services at the hospital have been rated as Inadequate since an inspection in December 2017.

Following its latest inspection on August 8 and 9 the CQC found patients attending the emergency department were still not always receiving a robust assessment of their condition during triage and there was a lack of accountability for patients in the waiting room.

Inspectors remained concerned about the speed and effectiveness with which staff responded to patients with serious and deteriorating conditions.

While an electronic tracking system allowed for patients to be assigned correctly within the department, staff did not monitor it effectively.

Some patients with suspected sepsis were still not being identified or managed properly and inspectors found staff who continued to be frustrated at the focus on sepsis and did not fully engage with the need to assess for the condition.

Care records were still not always written and managed in a way that kept patients safe and there was insufficient senior medical and specialist oversight; which affected the safety and management of patients.

However, the inspection also highlighted some improvement which included the ambulance triage area, which was seen to function more effectively and there was improvement in patient flow.

The trust has been told it must make improvements as a result of the inspection.

Systems and processes must be in place to identify and manage patients whose condition is deteriorating.

Staff must record accurate, complete and contemporaneous records of care provided to patients.

The trust must ensure all service users are safeguarded and protected from abuse and improper treatment.

Specialist clinical expertise must be secured to ensure expertise across the emergency department and clinicians should provide oversight of care provision, ensuring all patients receive care that is safe, effective, timely and in line with best practice.

Dudley South MP Mike Wood said of the report: "We have some really fantastic staff at Russells Hall and the hospital delivers many of the services extremely well, but the CQC inspections have highlighted some seriously unacceptable failings in the Emergency Department that urgently need to be addressed.

“I met with senior clinicians and the executive team at Russells Hall again last week to discuss steps the hospital is taking to improve its A&E services; as well as its worryingly high number of deaths from sepsis.

“I will continue to push for the improvements that are urgently needed at Russells Hall and to make sure there is clear accountability across the hospital’s leadership.”

Diane Wake, Dudley Group chief executive, said: "We are absolutely determined to make our Emergency Department the best it can be, and ensure our patients are safe.

"As a trust, we are moving towards a continuous improvement culture, and we welcome this assessment of the areas we need to focus our attention. Patient safety is our first priority. We have a clear action plan in place for improvement, which harnesses the dedication and commitment of our staff, as well as the support being provided to us by partner organisations.

"Since the August inspection, we have been working with the Emergency Care Intensive Support Team to embed improvements in urgent care.

"We have also forged valuable links with the Royal Wolverhampton Trust whose Emergency Department has been rated Good by the CQC, to share best practice."

To read the latest CQC report in full go to