• Shrewsbury and Telford Hospital Trust has received fourth warning from CQC
  • Safety regulator has sent letter to provider highlighting concerns about its ED streaming service
  • It follows CQC warning sent in September last year which raised concerns over levels of paediatric clinical staff within trust’s A&E

Shrewsbury and Telford Hospital Trust has received another warning from the Care Quality Commission over the safety of its services, HSJ can reveal. 

The trust, which was rated “inadequate” in November, has confirmed it has received a section 31 notice from the regulator, following an inspection in April. 

This will be the fourth warning SATH has received from the CQC in the last eight months, two of which were also formal section 31 notices. 

The trust’s latest warning relates to concerns over its emergency department, particularly the streaming of paediatric patients, a spokesman confirmed.

Edwin Borman, medical director for SATH, said: “We were not able to see all of our patients in 15 minutes, in line with national performance targets, and some of our patients left before we could start treatment. We have alerted our GP colleagues of any children who left our EDs before treatment, which was the main area of concern for the CQC.”

In October, HSJ revealed the trust had been sent its third CQC warning. In this, the provider was told it had until March 2019 to address concerns over levels of paediatric staff within its accident and emergency department, risk assessments for malnutrition and pressure ulcers not being carried out, and lack of consultant and nursing staff within the intensive therapy unit. 

Previous letters warned the provider about safety issues within its emergency department and maternity wards, one of which raised serious concerns over the boarding of patients within A&E. 

The news comes amid an independent review, commissioned by former health secretary Jeremy Hunt, into more than 250 cases of potentially poor maternity care.

In September 2018, the West Midlands Quality Review Service, which has carried out reviews of paediatric critical care services across the West Midlands, warned the trust’s emergency department did not have enough staff trained in paediatric resuscitation. 

Its report, published in December 2018, added: “Paediatric staff were only available 9am to 10pm Monday to Friday and 12 noon to 10pm on Saturdays and Sundays. A registered healthcare professional with level one Royal College of Paediatrics and Child Health competences was not always available at Royal Shrewsbury Hospital after 10pm when paediatric staff were not on site.

“Reviewers considered that a child could arrive and need resuscitation after 10pm and that a member of staff with appropriate competences to lead the resuscitation might not be available.”

Nigel Lee, chief operating officer at SATH, said: “In Shropshire throughout April we have seen huge increases in emergency demand with over 20 per cent more attendances and 30 per cent more ambulances at our emergency departments. Our staff are working incredibly hard to manage this demand whilst we await our new recruits who will start with us in June.

“The trust has approved spending over £1 million on additional staffing this year for our EDs and as these new nurses and doctors start, we can be confident the service will continue to improve and meet all of our obligations.”

Amanda Stanford, deputy chief inspector of hospitals at CQC, said: “CQC inspected the maternity and ED services at Shrewsbury and Telford Hospitals Trust in April. As a result we took further urgent action with regard to ED care, including paediatrics. We are unable to give further details at this time but will report on our findings shortly. All CQC’s action is open to appeal. We are monitoring the trust closely and liaising with NHSI and NHSE.”