• CQC inspectors raise concerns about dignity and safety of patients at Medway FT
  • Trust was given a warning notice after February 2024 inspection
  • It has apologised but says improvements have been made

The Care Quality Commission has reported on an emergency department with 55-hour A&E corridor waits, and some frail patients being told to soil themselves because there was no one to take them to the toilet, while another had to urinate into a bottle without privacy curtains.

The CQC received dozens of reports of “information of concern” from patients and staff about the A&E at Medway Maritime Hospital, run by Medway Foundation Trust, in the months before it visited in February last year.

When they did so, inspectors were told staff feared reprisals if they raised concerns and that band 7 nurses “lived in fear of punishment from senior leaders”. Less than half of ED staff felt safe about speaking up, according to analysis of NHS staff survey results.

The CQC apologised for the delay publishing the report, which was due to problems with its IT system, although it issued a warning notice at the time.

The department was rated “requires improvement” overall – previously it had been “good” – but was labelled “inadequate” in the area of safety, and for “kindness, compassion and dignity”. Under a new CQC scoring system, the department was rated 38 out of 100 for safety.

Inspectors found many patients had a poor experience, with inadequate staffing, overcrowding and medication delays.

There was no access to showers, despite some patients having stays of more than two days. Some were left in soiled clothing and bedclothes for hours.

Incidents were not always reported, with some staff saying they were discouraged from raising concerns and felt overwhelmed with overcrowding. There were problems with guidance on using “non-designated care areas” such as corridors. Staff were concerned about patients in corridors either not having call bells or these going unanswered.

The CQC said after the inspection the trust stopped using corridors, but staff said other inappropriate areas were then used instead. Inspectors saw 14 patients in a resuscitation area intended for nine, 19 patients in the majors area which should have held 10, and 15 patients in a corridor.

Despite this, many staff members said there was good team working in the department and with ambulance crews. The department was rated “good” for being well led.

Chief executive Jayne Black apologised for the failures and said: “Over the last year we have made significant improvements so that patients attending our emergency department are treated sooner, are cared for in areas more suitable for their needs, and receive appropriate and compassionate care.

“We recognise there is much more for us to do, particularly to reduce delays for patients waiting to be admitted to a ward, so that every patient receives the high standard of care that we aspire to provide.”

Since the inspection, ED waits, ambulance handover times, and patient feedback had improved, the trust said. It had introduced improvement huddles in the ED and opened a new 30-bed ward.

The latest NHS England data shows that 756 patients spent more than 12 hours in the department after a decision to admit in January, compared to 953 in January 2024.

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