Alder Hey Children’s Hospital A+E Listening Event Report - August 2023

Introduction

We held a targeted listening event in the Accident and Emergency Department (A&E) at Alder Hey. The rationale for attending the A&E is that we have received more mixed reviews for A&E than other departments. As Alder Hey is such a specialist hospital, wards often contain many children that live outside of Liverpool. We thought we may see a greater proportion of local residents by targeting A&E. Finally, we hoped that local feedback from the A&E would inform how patients are being directed by other services such as Walk-in centres and GP practices.

We attended the A&E on three occasions, Tuesday 29 August between 9am and 12pm, and between 5pm and 8pm and on Thursday 31 August between 9am and 12pm. We attended in pairs with staff members taking lateral flow tests prior. We confirmed our attendance and plans with staff before attending. 

Staff facilitated our visit and were keen to support us in getting open and honest feedback. We were given a tour of the facilities, introduced to A&E staff and the reason for our attendance shared.

Key findings

• Patients, Carers & Visitors were predominantly very happy with their experience at the Alder Hey A&E with only one family rating their experience as less than 3 stars.
• The majority of patients who attended were directed to A&E by other NHS services, mostly GP and walk in services with 3 families being directed by NHS 111.
• The majority of families who attended A&E had been there more than once in the last 12 months. Some families commented on improved waiting times and experiences compared to their last visit.
• Alder Hey A&E was a clean and welcoming environment with calming music and toys available.  There was a refreshment trolley available with water, cordial, baby milk bottles, spare nappies and vomiting bowls. We were pleased to see there is now a facility for parents to charge their devices as we recommended in a previous report.
• There were some parents who felt that there were not enough toys to occupy the children and others who felt that they did not see the toys cleaned often enough. When we spoke to staff they advised there was unfortunately a common problem of toys being taken from A+E by patients and parents.
• Waiting times for triage were impressive with only one family reporting waiting more than an hour and the majority reported being triaged in under 15 minutes. Only two families rated the triage experience as less than satisfactory.
• Satisfaction rates for staff was extremely high with no family reporting they found staff disrespectful to them or their children. Communication surrounding treatment and wait times was more mixed with a third of families unsure or feeling that these were not communicated well.
• We spoke directly to 6 children and all of them reported they felt safe when they were at Alder Hey all of the time they were there. All the children we spoke to advised that staff were friendly and kind to them all the time. All felt welcomed most of the time and all but one felt that staff listened to them and explained things clearly. 
• There are multiple baby changing facilities and also a sensory room that is advertised clearly for patient use. There are ample toilet facilities that are clean but perhaps could have better signage.