20.01.16
Poor A&E layout sparks Monitor probe at Great Western Hospitals
The health regulator has launched an investigation into the A&E at Great Western Hospitals NHS FT after a CQC inspection identified particular concerns with staffing levels and patient safety within the provider.
While the trust – previously probed for its £2.9m deficit in 2014 – was rated as ‘requires improvement’ overall, the inspectorate highlighted the string of improvements needed in the emergency department, for which it issued a warning notice.
The large trust, which provides acute and community services to around half a million people in Wiltshire and surrounding areas, still needs to modernise the design and layout of its A&E and improve patient flow, Monitor said.
The CQC found that the poor design meant that waiting patients, including children, were not being adequately observed. This physical isolation and lack of environmental safeguards posed “unacceptable risks” to patient and staff safety, with staffing levels not taking into account the requirement to care for patients queueing in corridors or the sub-waiting room.
Staff also need to be properly trained in the emergency department, including in how to manage and record patient data. The regulator said it wants to investigate why the trust is facing these specific issues and what its current improvement plans are.
The probe will also consider whether planned changes are set to happen quickly enough.
Claudia Griffth, regional director at Monitor, said: “Patients in Swindon and Wiltshire expect effective and quality care when they visit A&E; key to that is having the right amount of staff with the right skills to provide emergency care, and a well-designed and run emergency department. This helps to ensure that patients can be seen, treated and discharged quickly, or if needed, moved to a different part of the hospital to receive further care.
“We want to find out why the trust is facing these problems, and whether its leadership team has the right plans in place to improve its A&E quickly for its patients.”
Based on the findings, the regulator will determine whether further regulatory action is needed, although the trust has not been placed in special measures.
Prof Sir Mike Richards, chief inspector of hospitals at the CQC, commented further on the inspection’s findings: “We found a marked variation in the quality of the services between the acute hospital at Swindon and the services based in the community.
“There were particular concerns with staffing levels and how this compromised patient safety in the emergency department where people were queuing in corridors. The trust has not found it easy to manage the access and flow of patients through the Great Western Hospital. Both the acute and community hospitals faced a high number of patients who were fit for discharge, but had no care package in place.
“Although these issues were recognised and known, we found that the necessary improvements had not been made or sustained. However, the trust leadership was open about the challenges they faced and listened to our concerns. They must now work hard to meet the demands required.”
(Top image c. Barry Batchelor)