A hospital trust already placed in special measures and given three warnings over standards of maternity care is in a “crisis situation” according to inspectors, whose latest visit found blood-stained walls, severe overcrowding and a catalogue of potentially life-threatening practices.
The Care Quality Commission (CQC) is today issuing a formal warning to Medway NHS Foundation Trust, following an A&E inspection in December. Inspectors said they could not deem the care at the Medway Maritime Hospital to be safe. They said patients arriving by ambulance suffered most, with a lack of cubicles and trolley bays in A&E to provide sufficient assessment.
A mobile unit had been set up outside the hospital and was used as an “overflow area” where patients brought in by ambulance could be assessed, the report said. Many were forced to remain there longer than the 30-minute limit due to a lack of bays and beds in the main unit and too few staff. In the main unit, inspectors found patients waiting for hours on trolleys. Patients were also not near resuscitation or other vital equipment. It is the latest setback for the troubled trust, which already has three formal warnings over poor maternity care and was recently forced to appoint a new interim chief executive and chairman. The report said: “On our arrival in the department there were 20 patients who had been in there for more than four hours, waiting to be seen by doctors. Seven of these had been in the unit for over 11 hours and one patient had been there in excess of 19 hours.
One patient who was cold had asked for a blanket at 4am but had still not been given one four hours later. The report also depicted another elderly person who had been on a trolley for over 20 hours.
Inspectors also looked at cleanliness and saw “stained floors and dirty wash hand basins; and blood spatters on a wall in the [mobile] unit.
“The resuscitation area was cluttered with boxes and equipment on the floors including sharps bins. Single use resuscitation equipment was open and not covered or protected from cross contamination,” it said. Many curtains between cubicles were “visibly stained or dirty”.
CQC’s Adrian Hughes said the trust was taking steps to improve its services but there were too many patients for the capacity of the department. “It is clear that the work taking place to make improvements has not yet translated to better patient care in the emergency department,” he said.
Meanwhile outgoing NHS head Sir David Nicholson said he “bitterly” regretted not talking to campaigners and patients during the height of the Mid Stafford hospital crisis. NHS England’s chief executive said he made the “wrong call” for not seeking out patients and campaigners during a visit to the hospital in the wake of a report published in 2009.
He attributed the decision to not wanting to feed a “media storm”, adding it turned out to be the “biggest mistake” during his 36 years of service in the NHS.