- A&E doctors tell CQC inspectors department not safe due to overcrowding
- One patient waited more than 44 hours for a respiratory bed
- New trust CEO says he will not accept routine use of corridors for patient care
Accident and Emergency doctors at a Midland hospital trust have told Care Quality Commission inspectors their department does not feel safe, as one patient waited nearly two days for a medical bed.
The CQC carried out an unannounced inspection of the two A&E departments run by Worcestershire Acute Hospitals Trust in January, after concerns were raised about patient care.
The inspection report, published today, found the services were “stretched and overcrowded” at both the trust’s acute hospitals, Worcestershire Royal and Alexandra, with many people cared for in emergency department corridors and not treated in a timely manner.
CQC hospitals chief inspector Ted Baker said: “The service at both hospitals was obviously challenged and while risks to patients were being assessed, monitored and managed, the situation we found was clearly unacceptable.”
A review of 23 patients at Worcestershire Royal Hospital found only two had to wait for less than five hours, and seven had to wait for more than 24 hours. Eight of these patients were being treated in corridors and all had been waiting for more than 11 hours.
The report stated: “We saw that the patients waiting for a bed included a patient who had been in the department for 44 hours and 19 minutes whilst waiting for a respiratory bed. Several patients waiting for beds were frail and elderly. There were 12 out of 23 patients aged between 70 and 93 years, waiting between ten to 45 hours for a bed in a ward.”
Some doctors at Worcestershire Royal told inspectors “they did not feel the department was safe due to overcrowding”, while doctors at the smaller Alexandra Hospital in Redditch said more staff were needed to run a safe A&E department.
At Alexandra Hospital, there was additional frustration among staff about ambulances being diverted from the overwhelmed Worcestershire Royal.
The review noted: “Nurses told us they were not always consulted about ambulance diversions from Worcestershire Royal Hospital ED to the Alexandra Hospital ED, and told us they were often overwhelmed themselves to accommodate extra patients. Staff told us they felt the ambulance diversions were sometimes unfair.”
The corridors at Alexandra Hospital’s ED were so crowded that a fire exit was blocked by patients on trollies, which often had to be moved for staff to pass by. The inspectors witnessed “ED staff, porters and ambulance crews juggling with patient trollies and wheelchairs”.
The CQC said the trust must reduce ambulance handover delays, ensure patients are assessed and reviewed in a timely manner, and ensure there was adequate consultant cover at Alexandra Hospital ED.
Overall, the CQC found the staff at both hospitals were caring and compassionate even while under “extreme pressure”.
Responding to the report, trust chief executive Matthew Hopkins, who started in the role in January this year, said he recognised the CQC’s concerns that more needed to be done, and quickly.
He said: “We cannot – and will not – accept the routine use of corridors to care for patients, or the long waits that keep ambulances off the road, or the conditions that our ED teams are currently working in.
“That will require the active support and commitment of teams across our hospitals, as well as our partners, the local health and care system.”
The trust has opened additional beds at both hospitals since the inspection, which has helped reduce the use of corridors to care for patients, he added.
The inspection did not change the trust’s rating, which was already “inadequate” for both hospitals. The trust is also in special measures.
CQC report, information provided to HSJ