West Yorkshire's healthcare problems revealed in CQC report

Those pressures were particularly felt in the "stretched" ambulance service, causing staff mental and physical stress, while patients faced extremely long waits at Bradford Royal Infirmary (BRI).

The Care Quality Commission (CQC) carried out co-ordinated inspections between March and May across the West Yorkshire integrated care system (ICS).

The CQC report said improvements are needed across West Yorkshire

ICSs are new partnerships between organisations involved in health and care.

The CQC found services were under continued pressure and people experienced difficulties accessing urgent and emergency care.

As part of the review, 999 and NHS 111 services run by the Yorkshire Ambulance Service NHS Trust, as well as urgent and emergency care run by Bradford Teaching Hospitals NHS Foundation Trust and The Mid Yorkshire Hospitals NHS Trust, were inspected.

GP surgeries, urgent care out-of-hours services, and adult social care providers were also inspected, among others.

The CQC said staff across West Yorkshire “continued to work under sustained pressure” and while there was an effort to find new ways of working “people continued to experience delays in accessing care and treatment”.

Inspectors said some staff and patients reported difficulties with providing and accessing telephone appointments, while the NHS 111 service was experiencing “significant staffing challenges”.

The ambulance service has faced extreme pressure

There had been an increase in demand, particularly from people trying to access dental treatment.

“Due to demand and capacity issues, performance was poor in some key areas, such as providing a call back to patients from a clinician,” the CQC said.

People’s experiences of emergency departments were varied, the CQC said, while social care staff “experienced lengthy delays” in ambulance response times.

“Staff working in some social care services reported significant challenges in relation to unsafe discharge processes,” said the CQC.

The report added: “We found services were under continued pressure and people experienced difficulties accessing urgent and emergency care services in West Yorkshire.”

Inspectors said resources in the ambulance service were being “continuously stretched”.

“The delay in sending ambulances meant people were calling to the service a number of times to ask for updates or to provide new information if the patient’s condition changed,” said the report.

For Category 1 calls - the most serious incidents - performance as of April 25 was eight minutes and 18 seconds against a target of seven minutes; 33 minutes for Category 2 calls, against a target of 18 minutes, and 1 hour 28 minutes for Category 3 calls against a target of 40 minutes.

“The trust told us that the difficult and stressful nature of the role, and competition from other employers had also presented a challenge to recruitment," the report added.

“Some staff we spoke with acknowledged the mental and physical stress caused by the current pressures.”

The report said the exceptional pressure on the system meant “the risk to a safe and effective performance of the ambulance emergency operations centres was high”.

The pressures on hospitals were reflected in the report for BRI, which highlighted issues surrounding increasing sickness rates and increasing patient numbers.

The report said while managers and staff worked to make sure patients did not stay longer than they needed to, increasing numbers of patients attending urgent and emergency care services and wider pressures within the system, meant patients could remain in the department for up to 20 hours and in the case of some mental health patients, 30 hours.

At the time of the inspection, the longest wait was recorded as 17 hours and 48 minutes.

Ann Ford, CQCs director of operations network, said: “During the urgent and emergency care inspections across West Yorkshire, staff were working hard under sustained pressure.

“It was reassuring that leaders were working together to support their workforce and to identify opportunities where improvements could be made, however people continued to experience delays in accessing care and treatment.

“Across West Yorkshire, it’s important that service leaders continue to work together to improve patient pathways across urgent and emergency care, to alleviate pressure on other services and ensure people receive the best possible care.”

Dr Adam Sheppard, Chair of West Yorkshire Urgent and Emergency Care Board, said: “We are acutely aware of the challenges faced by our staff and by local people and are absolutely committed to working together across the whole of the system to better join up care and to deliver safe care for all.

“Our staff, volunteers and carers continue to work exceptionally hard, and they should be applauded.

“We will be putting together further actions to prioritise where we can improve following this substantial process.”