The Care Quality Commission (CQC) has told Medway NHS Foundation Trust that it must make significant and immediate improvements to the emergency department at Medway Maritime Hospital.
CQC carried out an unannounced focused inspection of the hospital’s emergency department in December, in response to increasing concerns about the safety of patients.
Inspectors identified delays in patients being transferred from an ambulance into the department and poor patient flow, with people experiencing substantial delays before being admitted.
As well as the delays and lengthy waiting times there were concerns that patients were not being monitored effectively, that patients were not receiving the necessary timely clinical care when needed and care records were incomplete.
After the inspection a warning notice was issued to the trust requiring action to mitigate the risks to patient safety posed by ambulance handover delays and improve patient flow through the emergency department.
Overall the emergency department is now rated as Inadequate. The department is rated as Good for being effective and caring but inadequate for being safe, responsive to people’s needs and well led.
CQC’s Deputy Chief Inspector Hospitals for London and the South, Nigel Acheson, said:
“We saw that staff were working hard to provide care to patients in very challenging conditions.
“Given the pressure the trust was under, the decision to inspect during this period was a difficult one. However, we had significant concerns from reviewing our own data, the views of healthcare system partners and information shared by people who worked for and used the service. We had a duty to inspect to support the trust and identify where improvements needed to be made.
“After the inspection we told the trust leadership of our concerns and issued a warning notice to ensure the necessary improvements not only took place but were embedded.
“Since the inspection, the trust has developed a detailed improvement plan. We will continue to monitor the service and will not hesitate to take further action if required, in accordance with our legal powers.”
Inspectors rated the service Inadequate for the following reasons:
- Staff did not always keep detailed records of patients’ care and treatment when completing records for urgent and emergency care patients. This included the completion of nursing care, falls and skin risk assessments.
- Care for patients showing signs of deteriorating were not consistently escalated, placing patients at risk.
- The department did not always control infection risk well, increasing the risk of cross infection.
- There was poor flow out of the department, patients experienced substantial delays before being admitted or discharged.
- The leadership, governance and culture did not always support the delivery of high-quality person-centred care for patients.
Full details of the inspection are given in the report published online here.
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