• Children not being treated by nurses with the right competencies, finds CQC 
  • Inspectors “alarmed by what they found” at Pilgrim Hospital
  • Patients have been receiving care in corridors 

Children have been put at risk of harm in the emergency department at Pilgrim Hospital in Lincolnshire, the Care Quality Commission has found.

The CQC carried out a focused inspection on 30 November following concerns raised about the standard of patient care in the emergency department. 

It found children being treated in the emergency department were “placed at risk of harm” as they were not being looked after by nursing staff with the right competencies to provide safe and effective care. 

Ted Baker, CQC’s chief inspector of hospitals, said inspectors were “alarmed by what they found” at Pilgrim Hospital.

“Of particular concern was the fact that acutely ill patients were not prioritised and treated quickly, with inspectors needing to intervene in the care of patients to ensure their safety,” Professor Baker said.

“We raised immediate concerns with the trust and NHS Improvement and were clear that urgent action was needed to keep people safe,” Professor Baker continued. “We then made another unannounced inspection of the emergency department earlier this week to check that the most serious of our concerns had been addressed.

“We found that the department was better organised and steps had been taken to address crowding concerns – but it was obvious that there are still significant further improvements needed.”

The department’s staffing levels were “not sufficient” to meet patient needs and there was “no capacity to assess and revise staffing levels”, the regulator found.

Inspectors found “serious concerns” surrounding triage, assessment and monitoring of patients in the department, particularly patients who were acutely unwell, as they were not treated as a priority. 

There were “significant issues” found in relation to patient flow, which led to patients receiving care in corridors and waiting up to 65 minutes to enter the department when arriving by ambulance. 

The regulator found Pilgrim Hospital’s leadership team to be ineffective, with a “lack of co-ordination” between different senior leaders.

It was also found the consultant in charge had no awareness of the increasing wait for senior review or ambulance handover delays.

The CQC inspectors discovered the hospital’s “red flag” system, which indicates patients which need to be seen by a doctor before other patients, was “ineffective”. The inspectors cited an example of a child with possible sepsis who waited over 90 minutes before being reviewed by the consultant in charge. 

Kathy McLean, executive medical director and chief operating officer of NHSI, said: “CQC’s findings lay bare the unacceptable standard of care in the emergency department at Pilgrim Hospital. While there has been some progress, more needs to be done and at pace.

“In response to CQC’s report, we are intensifying our support by introducing daily calls to review the department’s progress and the trust has deployed a clinical lead and matron to provide advice on site.”

HSJ reported earlier this week the Unite staff side committee had passed a vote of no confidence in United Lincolnshire Hospitals Trust, which runs Pilgrim Hospital, due to patient safety fears.