the service is performing exceptionally well. Several services are provided in temporary buildings offering poor quality accommodation and others are past their useful life. However there was poor access to sinks in the unit, which did not comply with health building note HBN 00-09, (infection control in the built environment; hand hygiene facilities, clinical wash-hand basin provision). The current model is unsustainable. The survey of bereaved relatives results were positive in relation to dignity and respect afforded to patients. Our ability to manage demand has been constrained by the inflexibility of the estate. Staff in the medical service did not always assess swallowing abilities in a timely manner. Staff we spoke with across the team were passionate about their roles and proud of the trust. Figure 8sets out the site-specific running costs and area of the estate. Our general switchboard number is 01302 366666. This area also houses some of the UKs major strategic national assets. Preparation room: currently 7.6 square metres (HBN recommends 12 square metres). FY3 8NR. The service had previously experienced issues with effective team working and had challenges in building team resilience and communication. Something went wrong, please try again later. Issues around estates and environment were on the directorate risk register and had been identified as a not met against National D16 commissioning service specifications for critical care services, during an assessment by the LSCCCN. Maybe need another 8h in waiting room to get dose of painkillers. Many of the wards and departments are very worn, with surfaces that are not intact and, as such, are unable to be adequately decontaminated. Compared to the HBN standard, a typical 28-bed ward at RPH would need to increase capacity by 220% to comply with current space standards, as illustrated inFigure 10. We will publish a report when our review is complete. The staff throughout the hospital knew how to make referrals and people were appropriately referred to and assessed by the specialist palliative care team in a timely manner, therefore individual needs were met. The use of patient diaries had been embedded in practice since our last inspection. Figure 11: Comparison of current theatre capacity compared to HBN 10-02, Figure 12: Example of increased ward space required to meet HBN space requirements within the existing ward block at Royal Preston Hospital. Nurses do the heavy lifting, I dont understand they are just as qualified in fact I can bet nurses are better at doing IVs than doctors because they do it all the time wheres doctor looks at you, scribbles something down or better yet gives you paracetamol and sends you to another place to deal with you.