09.06.16
Portsmouth Trust to lose registration unless it addresses A&E overcrowding
Serious delays in seeing patients at Portsmouth Hospitals NHS Trust mean that the CQC has given it an inadequate rating and placed conditions on its licence.
CQC inspectors rated the trust as ‘inadequate’ for urgent and emergency services and ‘requires improvement’ for medical care after unannounced inspections in February and March found the A&E overcrowded, with ambulances waiting outside.
The trust’s licence is now conditional on it ensuring patients are treated in a timely way at Queen Alexandra Hospital A&E; ending the practice of using its large multiple occupancy ambulance, known as the Jumbulance, to accommodate patients; and ensuring effective leadership within the emergency department.
Professor Edward Baker, CQC’s deputy chief inspector of hospitals, said: “On previous inspections we have expressed our concerns about the flow of patients through the emergency department and into the hospital, as well as the hospital’s reliance on using the Jumbulance to accommodate patients needing urgent attention. If the patient flow through the hospital was effectively managed there should be no requirement for the Jumbulance unless there was a major emergency.
“It is a matter of some concern that, despite previous assurances, the trust has been failing to manage emergency admissions and this has been affecting partner organisations who may already be stretched beyond capacity.
“While we have placed conditions on the registration, it is clear that the trust cannot achieve these improvements on its own. It will require the combined determination and effort of the whole health and social care community in the area to ensure that the level of service that the people of Portsmouth are entitled to expect is consistently provided.”
The inspection found that problems at Queen Alexandra were affecting other hospitals. Patients were being diverted to Southampton General Hospital and Solent NHS Trust, putting pressure on their services.
Overcrowding was so bad that South Central Ambulance Service sometimes had a third of its south east Hampshire fleet queuing outside the emergency department, meaning that their response times were not met.
There were two serious incidents where they were not able to meet response times for life threatening conditions, including a road traffic accident on the M27 where a tent had to be erected whilst waiting for an ambulance.
The inspection also highlighted other areas for improvement, including delayed discharges, safe storage of medicines and patient notes, and staff failure to adhere to infection control procedures.
A spokesperson for the trust said: “It will take time to make all the necessary improvements but we are determined to ensure that by the time of maximum demand in our emergency department, next winter, our service will be better.
“We have changed the way in which some patients are admitted to the acute medical unit, redirecting those patients who do not need the clinical skills of the ED (emergency department team) to other pathways and promoting the fact that GPs can refer urgent patients directly to ambulatory services and our outpatients clinic.”
The CQC announcement comes on the same day as the monthly NHS performance figures, which show that waiting times in A&E continue to be a problem across the country, with only 90% of patients being seen within four hours, below the 95% target.
(Image c. Chris Ipson from PA Wire)
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