Concerns raised about Bath A&E department
Inspectors have highlighted staff shortages and the layout of the department
Concerns have been raised about the state of the A and E department at Bath's Royal United Hospital (RUH).
The Care Quality Commission (CQC) rated the emergency department as “requires improvement” after a focused inspection in January to assess its handling of winter pressures on the NHS.
A report published this week (10/03) said social distancing was difficult and could lead to overcrowding, while demand on services meant some patients had to wait in ambulances before they could get a bed.
Several positive comments are also made in the report however, including that the hospital controlled the infection risk well, it was better than the national average for patients waiting more than four hours, and no one waited more than 12 hours for a bed.
Amanda Williams, the CQC’s head of hospital inspection for the south, said: “During our inspection of Royal United Hospital Bath we found a team that was focused on safety and protecting patients from infection during a very difficult and challenging time.
“However, high levels of demand on the emergency department were impacting on patient waiting times and we had concerns about staffing levels, particularly at night, and in the paediatric department.
“Yet despite these pressures, there were many examples of good practice. Leaders were aware of current challenges and were in the process of making improvements.
"We continue to monitor the trust and will return in due course to check on the progress of improvements we’ve told them to make.”
Concerningly, the CQC said the emergency department did not always have enough staff with the right training to keep patients safe from avoidable harm and at times they did not always provide the right care and treatment.
On top of that, the treatment of children was not always carried out by a nurse with the relevant training because of a national shortage of paediatric nurses, although it is noted the trust has its own in-house training programme to address this.
The inspection report said the layout of the department and narrow dimensions of corridors made social distancing difficult. At busy times some patients were asked to wait in an area where they could not be seen by staff, but they were told to return to the department if their condition worsened.
The inspectors were also concerned about the complex layout’s impact on senior medics’ ability to see patients. These issues are set to be addressed through a £2.5million building programme.
The CQC said trust leaders understood the issues the hospital faced and the additional pressures of the Covid-19 pandemic and the infection risk was well controlled.
In response, a spokesperson for the RUH said the trust welcomes the CWC's report.
"We are encouraged by the Commission’s favourable and positive comments, praising our team in particular as focused on safety and protecting patients from infection, and citing many examples of good practice," they said.
"However, we and the CQC recognise the impact of heavy demand on services. We also share their concerns about staffing levels at what was a particularly busy time of the coronavirus pandemic.
"We note and will address the CQC findings.
"Work is already well underway on a £2.5m building project that will further improve our emergency care facilities.
"This will increase capacity, enable patients to be seen quicker, and speed the flow of patients from ambulance to emergency department treatment."