NHS IT, Records and Data

16.04.19

A&E patients ‘poorly managed’ and workers overstretched at Portsmouth hospital

Patients are being “poorly managed” and the frail and elderly are left in “unacceptable states of undress” by overstretched staff at a Portsmouth hospital, the CQC has found.

Inspectors have told the trust that runs Queen Alexandra Hospital that its emergency department must improve after the latest inspection, which was unrated, found a number of concerns.

The CQC said the flow of patients through the emergency department was being “poorly managed,” and that part of the problem was that the designated nurse-in-charge was overstretched, distracting them from undertaking a command-and-control role.

The waiting times did not have enough seats to accommodate patients, and at peak times they were left standing for extended periods of time, with delays caused by the congestion.

Inspectors said at times the privacy and dignity of patients was not protected, with cases of nursing staff failing to cover patients up or half closing cubicle curtains.

In March 2016, the CQC found an “unacceptable” risk to patients in the emergency department and rated it “inadequate” but this was raised in 2017 to ‘requires improvement.’

Nigel Acheson, CQC's deputy chief inspector of hospitals for the south, said: “When we visited the Queen Alexandra Hospital emergency department, we did see improvements from previous inspections although clearly there is still work to be done.

“Handovers from ambulance teams to hospital staff were still taking too long at times.

“The trust’s work to reduce pressures on the emergency department are welcome – but we note that patient movement through the department is still a problem during busy times and this must be addressed. We will continue to monitor the trust closely and will return to inspect again soon.”

The CQC said there was an appetite among staff to improve the quality of emergency care the department provided, and were told that a range of acute medical pathways has been established.

This is part of the Portsmouth Hospitals NHS Trust Emergency Floor Programme to reduce demand on the emergency department, which includes a consultant-led telephone advice line to help patients who might not need to attend hospital.

In a statement, chief executive of the trust Mark Cubbon said that staff were “working against the backdrop of increasing pressures” and that the number of patients using the department had increased by 1,300 compared to last year.

He said: “We fully recognise that it is not acceptable for any patient to wait longer than they should and no matter what the operational pressures, our focus on patient care and experience must remain paramount.”

Image credit - Chris Ison/PA Archive/PA Images

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