• CQC finds some signs of improvement but still has significant concerns about Pilgrim Hospital
  • Regulator will continue to monitor the trust closely

Children being cared for at a district general hospital’s emergency department are at risk of harm, the Care Quality Commission has found, shortly after raising similar concerns late last year. 

Although there was a registered children’s nurse in the department at the Pilgrim Hospital in Boston, Lincolnshire, there was “no oversight” of new arrivals to the department and children were being triaged by staff without paediatric competencies, the regulator said.

It carried out an inspection on the emergency department in December to check on the progress made following a focused visit in November after concerns were raised about standards.

The hospital is run by United Lincolnshire Hospitals Trust, whose overall CQC rating is “requires improvement”. HSJ reported last year that the Unite staff-side committee at the trust had passed a vote of no confidence in the trust because of patient safety fears.

Although there was more triage taking place, the CQC reported that it found patients were still not being assessed in a timely way. They found there was an “unreliable and inconsistent system” in place to identify critically ill patients who presented to the department.

The CQC found patients arriving by ambulance were left on the vehicles for “significant” amounts of time, despite presenting with a medical condition with the “potential to deteriorate”.

Patients in the ambulance corridor went for long periods without observations, which were not always completed in line with trust protocol, the CQC found.

Amanda Stanford, deputy chief inspector of hospitals, said: “We found some signs of improvement at Pilgrim Hospital, with nurse and medical staffing levels and a skill mix sufficient to meet the needs of patients.

“There remain a number of significant concerns with the hospital’s urgent and emergency care. Although triage staffing levels had increased, there were still issues around the early detection of critically ill patients and we saw children being triaged by nurses who didn’t have additional skills in paediatrics.”

She urged the trust to take “further action” to ensure these concerns are addressed so patients can receive safe care.

She said: “We are working with NHS Improvement and we will continue to monitor this trust very closely. This will include further inspections in the near future.”