Staffing and overcrowding flagged in Gloucestershire inspection

While the inspectors found the acute trust’s services to be safe and caring, they flagged the lack of consultants in acute and emergency medicine and delays in ambulance handover times.

The CQC also said the trust must also do more to report incidents, particularly near misses.

The trust is responsible for providing acute specialist and elective care across three sites: Gloucestershire Royal, Cheltenham General and Stroud Maternity Hospitals.

The regualtor also raised concerns that bed occupancy across the trust was constantly over 91 per cent, a level broadly accepted to affect the quality of care provided to patients.

While staffing was found to be at safe levels in many services, inspectors found a shortage of consultants in acute medicine, general and old age medicine, with more junior doctors needed in medicine and emergency care.

Chief inspector of hospitals Sir Mike Richards said: “In relation to safety, there are other significant factors such as the pressure on the emergency departments and the related pressures on the wards to discharge patients.

“This has led to patients not always being treated on the most appropriate ward for their condition and to overcrowding in both emergency departments.”

The inspectors, who visited the trust in March, found every service to be caring, with “outstanding” critical care at Gloucestershire Royal and Cheltenham General hospitals.

In its report the CQC highlighted several areas of outstanding practice, including: 

• patients living with dementia at Gloucestershire Royal being encouraged to maintain their skills and independence by taking part in an activity group with their relatives;
• a mobile chemotherapy unit which enabled patients to receive treatment closer to home; and
• the care for bereaved relatives and patients nearing the end of life

Trust chief executive Frank Harsent called the report “an important opportunity for us to reflect on feedback and improve our services”.

He said the trust has already begun to address the areas the CQC highlighted for improvement.

“Clearly the winter was a very challenging period for us and this has had an impact on our performance,” he added.