Bradford Royal Infirmary

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 assessed key questions within the effective domain and rated it as requires improvement. We saw evidence the service monitored and improved outcomes as well as assessing peoples individual needs appropriately.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had relevant information promoting healthy lifestyles and support on wards. For example, we saw leaflets containing information on chronic diseases such as diabetes in patient areas. There were posters displayed to raising awareness of mental health which signposted families and carers to sources of practical help. Patients told us they had been fully involved in their care and were aware of next steps, staff were attentive and provided quality care.

Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients' consent. They knew how to support patients who lacked capacity to make their own decisions or were experiencing mental ill health. They used measures that limit patients' liberty appropriately. Staff made sure patients had enough to eat and drink, including those with specialist nutrition and hydration needs. For example, staff used a nationally recognised screening tool to monitor patients at risk of malnutrition. We observed additional comfort rounds taking place with options for biscuits, juice, tea, and coffee. Specialist support from staff such as dietitians and speech and language therapists were available for patients who needed it. Staff monitored patients’ fluid intake throughout the day.

Staff followed up-to-date policies to plan and deliver high quality care according to best practice and national guidance. Staff we spoke with had a good understanding of the Mental Health Act, they followed guidance and could access support if required. Managers we spoke with had oversight on care and treatment and told us they ensured that staff were following guidance. We were told there was extra support available for staff to ensure they were up to date with evidence-based practice in the form of a practice development team. Staff we spoke with explained how they accessed the most current best practice guidance online and trust intranet, for example NICE guidance. Compliance against policy was monitored throughout the year using an annual trust audit schedule.

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

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.

Staff gave patients enough food and drink to meet their needs and improve their health. They used special feeding and hydration techniques when necessary. The service made adjustments for patients’ religious, cultural, and other preferences.

Shared learning was a significant focus for staff and there was evidence of detailed, multidisciplinary investigations of incidents and complaints that led to improved practice and training. The service provided care and treatment based on national guidance and evidence of its effectiveness. Managers checked to make sure staff followed guidance. Staff assessed and monitored patients regularly to see if they were in pain.

The service participated in relevant national clinical audits. They submitted data to the National Audit of Care at the End of Life. Patient outcomes in national audits were in line with the England average. Antimicrobial stewardship and sepsis programmes were well established with a rolling, comprehensive programme of audits and substantive training programmes for staff and doctors. The Trust were carrying out ‘improving blood cultures pathway work’, the rate of blood cultures contamination rate was approximately 2.17% and the Trust had an improvement piece of work ongoing for this area to improve outcomes.

The service regularly reviewed the effectiveness of care and treatment through local and national audit. We saw that following audit, there were recommendations and actions for improvement, which included allocation of lead responsibility, completion dates and evidence to demonstrate that actions had been completed. The National Audit of Care at End of Life for 2020/ 2021 showed compliance for key themes such as staff confidence, staff support, care, and culture which within expected range. We saw that 98% of patients admitted to (AMU) had their venous thromboembolism (VTE) risk assessed during their hospital stay in the most recent audit completed. The most recent stroke audit of 2024 showed 82% of patients had the correct diagnosis on discharge summaries.

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.