Urgent action taken as Medway A&E remains in 'state of crisis'

A spokesman for the CQC would not reveal details of the further action being taken for “legal reasons”.

During the inspection at the end of July, the team saw one patient, who arrived at A&E with a “potentially life threatening infection”, that waited over four hours for their first dose of antibiotics. Also, children were not given an initial assessment, which is against national guidelines. This included one child who had a head injury and had been waiting an hour without being assessed.

The inspection team said it was a “regular occurrence” for patients to wait in A&E for more than 12 hours because of delays in the decision to admit.

• Kent special measures trust could be first to face extra regulatory action
• More news and resources on Medway Foundation Trust

The report said: “The team had significant concerns surrounding the apparent inability of the department to cope with even a routine number of patients attending, let alone when surges of activity occur.

“Staff appeared resigned to the situation, and long patient waits for even urgent treatment had become normalised.”

The surgical department was also unable to cope with demand. The report said: “During the inspection, it was apparent that the department was struggling to cope with patient flow, appropriate bed allocation and timely discharges.”

The July inspection was the second unannounced visit of the hospital’s A&E department. The first inspection in December was prompted by concerns raised by an anonymous source. Inspectors also visited the department again at the end of August and the report from that inspection is due to be published in the next few weeks.

Medway Foundation Trust is taking steps to make improvements, which includes bringing in an emergency consultant lead and matron from Homerton University Hospital Foundation Trust to spend two days a week in the department “in supporting and advisory roles”, according to a trust spokeswoman.

Medway emergency clinicians will also spend time at Homerton to see how its A&E operates. Homerton’s emergency department was recently rated “outstanding” by the CQC.

University Hospitals Birmingham Foundation Trust, which is “partnered” with Medway, is already working with the trust to look at where changes can be made. Monitor has also brought improvement director Mark Davies into the trust.

The trust has recently employed a new chair and acting medical director.

Shena Winning, a chartered accountant who was previously a non-executive of the trust, has taken on the role of chair and Paul Ryan is acting medical director.

CQC’s chief inspector of hospitals, Sir Mike Richards, said: “We are urgently working with Monitor and NHS England to protect and promote the safety and welfare of people using the department.”

Medway’s acting chief executive Phillip Barnes said he recognised that “improvements need to be achieved” and that “some changes have not been made at pace”.

He added: “To improve privacy, dignity and experience for those patients coming to hospital for surgery, in August we opened a new pre-operative care unit. The unit provides 16 discreet and comfortable cabins where patients can be assessed, change into theatre wear and wait, before they are taken to the operating theatre for their procedure.”