Our Quality Account - have your say!
Our priorities are grouped into three areas. The first group relates to patient safety, the second is patient experience, and the third is clinical effectiveness.
Please click on each of the titles below to learn more about our patient safety priorities, and then vote for which of them you think we should prioritise. Once you have voted you will be taken to the next category.
Unnecessary CT urography exposes younger patients to avoidable radiation and contrast risk.
A locally performed audit entitled “Justification of contrast enhanced CT urography for investigation of haematuria in adult patient under 40-year-old’’ demonstrated poor compliance with best practice national guidance.
Result: Justified CTU requests: 35%
(National Best Practice Standard: 100% )
Timely recognition and escalation of deteriorating patients is fundamental to safe care. Where deterioration is not identified early, or escalation is delayed or ineffective, patients can experience avoidable harm – including preventable ICU admission, cardiac arrest, prolonged length of stay, and death.
This priority is proposed because we are seeing a pattern of:
These incidents represent a high-risk and high-frequency harm theme, requiring a coordinated Trust approach that strengthens reliability, clarifies accountability, and reduces variation across wards and teams.
Diagnostic delays are a significant patient safety risk, particularly where missed results, delayed imaging reporting, or patients lost to follow up lead to moderate harm or above. These events meet the threshold for notifiable Patient Safety Incidents (PSIs) under the statutory Duty of Candour, as they involve:
Across the reporting period, several cases resulted in high harm outcomes attributed to delays or failures within the diagnostic pathway. This includes incidents where earlier detection would likely have altered the clinical course, requiring Trust level review, Duty of Candour compliance, and learning-based improvement.
This is a current priority option for 25/26 Quality Account – further improvement work identified.
Nationally, the country has experienced an increase in mental health presentations, which has been further exacerbated by the pandemic. Mental health beds have also reduced by approximately 15% since 2010. Patients are increasingly presenting with complex mental health needs and require intensive support leading to patients remaining longer in acute general hospitals.
Locally, there has been an increase in patients with mental health needs attending general acute care settings over the last three years. Consequently, the length of stay (LoS) for these patients has increased, necessitating the admission of patients whose sole reason for attending the general hospital is a psychiatric disorder into acute medical beds. Not only does this reduce the availability of beds for medically unwell patients, it places additional pressure on ESHT resources ( infrastructure, human resources, estates, IT, security , visitors and patients). In emergency departments, patients were not always provided with a safe, therapeutic environment and staff feel unsupported and unprepared to meet the mental health needs of their patients.
This has been proposed as a Quality Account priority because it aligns to the Trust’s core safety responsibilities and the need to strengthen reliability across key maternity safety processes, particularly in areas associated with:
Unexpected deaths are among the most serious patient safety outcomes. Where review information suggests significant contributory factors (e.g., delays in assessment, missed deterioration, diagnostic delay, gaps in treatment, communication failures, pathway non-adherence, or system constraints), there is a clear need to strengthen the Trust’s ability to:
This priority reflects the importance of robust “learning from deaths” processes and the need for consistent governance assurance that suspected contributory factors are recognised, investigated, and acted upon – particularly in high-risk cohorts (frailty, multi-morbidity, complex care pathways) where deterioration may be multifactorial and escalation pathways can be challenged.
Current incident trends indicate:
Given the preventability of most pressure ulcers and the severity of harm associated with deeper grade injuries, this area has been identified as a key priority for improvement across acute and community services.
Slips, trips and Falls consistently remain in the top 3 themes for Patient Safety incidents at ESHT and although the inpatient falls rate per 1000 bed days was 2.39 (December 2025) and remains within the control limits with no cause for concern, we do have falls which lead to a moderate or severe level of harm whilst within our care.
In 2025 the trust reported 3 severe and 22 moderate levels of harm following an inpatient fall at ESHT.
Children and young people’s mental health is a growing concern, with increasing demand for services and a need for early intervention and support.
Strengthening communication and collaboration between different services is crucial. This includes improving referral pathways and information sharing between organisations.
