• CQC warning letter to severely challenged trust
  • Says board could not rely on patient safety risk information
  • Patients missed medication doses
  • Others cared for by untrained staff

A hospital trust where several patients died on trolleys amid intense emergency pressure last month has serious failings in governance and capacity, as well as care quality, inspectors have said.

The Care Quality Commission also found “untrained staff” were left alone to care for patients at Worcestershire Acute Hospitals Trust; patients missing medication doses while waiting for long period of wards; and children with mental health issues being cared for in corridors.

The regulator’s warning notice sent to Worcestershire Acute Hospitals Trust on 27 January, published yesterday, revealed a “lack of an effective plan to address the significant capacity issues” in its emergency department and said “the board cannot rely on processes in place or the information they are receiving” to identify or address risks.

It has been given until 10 March to address serious safety and quality concerns.

Amid huge pressure on the trust’s emergency departments around the turn of the year, health secretary Jeremy Hunt said Worcestershire was the trust the Department of Health was “most worried about”.

The CQC’s notice, known as a Section 29a letter, said: “The trust’s governance system in relation to the management of risk is not operating effectively to ensure that senior leaders and the board have clear oversight of risks affecting the quality and safety of care of patients and the need for significant improvement remains.

”The board cannot rely on the processes in place or the information they are receiving in order to take assurance that risks are identified and actions taken to reduce the risks to patients.”

The CQC had visited in November and December.

It also said: “We found that there was a lack of an effective plan to address the significant capacity issues causing crowding in the emergency departments (EDs) at Worcestershire Royal Hospital and the Alexandra hospital in the short or medium term.”

It said the trust did not have sufficient consultants in ED and that patients in the Worcester Royal Hospital clinical decisions unit were regularly left alone with untrained staff whilst trained staff took their meal breaks.

“This risk had not been identified by senior nursing staff in the departments and was not documented on the divisional or corporate risk register,” the CQC said.

It said doses of “critical medication” were not being administered to patients at the correct time and added: “At Worcestershire Royal Hospital we found two instances where patients did not receive Parkinson’s and diabetic medication, as they were being cared for prolonged periods in the corridor where medicine rounds did not occur.”

The CQC also gave one example of a child admitted with a mental health condition being cared for in a hospital corridor.

A spokesman from the trust said: “The CQC Section 29a letter is an important milestone in our quest to improve our services.

“The trust fully accepts the content and recognises that from the board across to our wards and other departments we have responsibility to solve our own problems and we are determined to use this letter as catalyst to bring out real and sustained improvement.”