Pressures facing A&E staff are 'extremely challenging' with patients waiting too long to be seen, inspectors have found.

The Care Quality Commission says urgent and emergency services at Royal Stoke University Hospital need to improve, following an inspection in March.

CQC inspectors noted the 'considerable' increase in ambulance handover delays at the Royal Stoke, along with the use corridor care, which was 'entirely unwanted and of a constant worry' to staff, patients and relatives. They found that while patients could access the service when they needed it, they did not always receive care promptly, with some waiting 24 hours or more.

But patients also told the inspectors that staff treated them well and with kindness. And all staff who spoke to the inspectors said that they had concerns over the number of patients who attended who did not need to be seen at an emergency department.

The CQC has again rated the service as 'requires improvement', due to the ambulance handover delays, patients not being seen in a timely way, and risk assessments not always being completed. Individual ratings of requires improvement issued in the 'safe' and 'responsive' categories, while 'well-led', 'caring' and 'effective' were rated as good.

The CQC report states: "The pressure on the limited number of staff trying to care for the patients while endlessly running around to deal with their needs was extremely challenging. We believe actions to relieve this pressure and make the area safer was crucial. We saw many examples of patients having long delays on the back of ambulance vehicles and in the emergency department, many on trolleys and on the corridor.

"Patients said staff treated them well and with kindness. We spoke with patients receiving care on the corridor, some patient voiced their dissatisfaction about the amount of time they had been waiting, however, many patients spoke highly of the staff and the care they provided."

The inspectors found that the service did not always have suitable facilities and equipment to safely meet people's needs. But they also noted that safety huddles were held throughout the day to discuss people's care, and that staff completed assessments for people at risk of self-harm.

Ann-Marie Riley, chief nurse at University Hospitals of North Midlands, which runs the Royal Stoke, said that improvements had been made at the emergency department since the inspection was carried out.

She said: "Delivering safe, high-quality care to people in our emergency departments is a top priority and we work closely with all our teams in our hospitals to ensure patients receive the most appropriate care possible at all times.

"This report is based on an inspection more than 10 months ago and a number of improvements have been made since that time. We are committed to continually improving services for our patients so they receive the highest standards possible."

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