The inspections of urgent and emergency care and medical care services found concerns about the environment and staffing levels.

In the emergency departments one person spent 21 hours on a stretcher before staff moved them to a bed at Royal Derby Hospital, while at Queen's Hospital, people sat or lay on the floor because there wasn't enough space on busy evenings.

The emergency department at Royal Derby Hospital's had 12 nursing vacancies and a sickness rate of 10%, with staffing levels not expected to reach the levels needed for many months.

Sepsis screening rates at Royal Derby's medical care remained at around 50–60% against a 90% target despite repeated audits and plans to improve, putting people at risk of delayed time-critical treatment.

Only 59.3% of staff at Royal Derby's medical care felt safe to speak up about concerns, and just over half of those who experienced bullying or harassment had reported it.

Dr Gis Robinson, executive chief medical officer at University Hospitals of Derby and Burton NHS Foundation Trust, said: ‘The inspection took place during one of the busiest winter periods we have experienced, with A&E demand more than 10% higher than the previous year, and while the reports reflect some of the pressures associated with very busy emergency departments, they also recognise the kindness and professionalism of our staff.

‘While many of the issues highlighted reflected challenges we were already working to address, we know patients should expect better and, since the inspection, we have reduced the time patients wait for an initial assessment, recruited additional staff, improved medicines management and made better use of space within our emergency departments.

‘We remain committed to building on these improvements, including planned building work to improve A&E facilities at Royal Derby Hospital next year, to enhance care, safety and experience for our patients and support our staff to provide the high-quality care they want to deliver.'