The Care Quality Commission has carried out a focused inspection of Wirral University Teaching Hospital NHS Foundation Trust’s urgent and emergency services at Arrowe Park Hospital.
CQC inspectors visited Arrowe Park Hospital unannounced on 4 March 2019, looking specifically at the urgent and emergency services, as part of the winter inspection programme. The department was previously inspected in March 2018 as part of a trust wide inspection and rated Requires Improvement, well-led was rated as Inadequate.
The latest inspection report is unrated, and the trust’s overall rating of Requires Improvement is unchanged.
Ellen Armistead, Deputy Chief Inspector of Hospitals, said:
“It is positive to note that staff and leadership were largely working well together to improve the care being delivered and drive the service’s overall performance forward.
“However, some patients did wait a long time to be seen and we had some concerns over how patients were being assessed when arriving at the hospital, a view shared by all the staff we spoke to about it. We also saw how patients were being treated in the corridors which could affect their dignity and, at the time of our inspection, the flow through the service was poor, creating additional pressures.
“We will continue to monitor the trust closely and return to inspect again soon.”
Inspectors saw how most staff were working efficiently with each other, and other healthcare providers, to minimise disruption to patients and were proactive in seeking better ways to improve care to patients with complex needs. Senior management were present in the service during peak times and staff spoke positively about their leadership, stating they were approachable and ready to actively support staff. Inspectors found that staff were happier and that the trust had worked well to improve the working culture and overall engagement in the service, despite months of significant pressure.
However, there were concerns that the trust had little oversight of the training and performance of the streaming service, which initially assesses and directs patients for treatment, staff expressed worry about the safety of the arrangement. Inspectors reported that privacy screens could not be used when treating patients in corridors due to the physical layout of the service, this meant patients’ dignity could be compromised when examined. There were also significant delays in treating patients and the patients’ journey through the service was not meeting demand placing additional pressure on staff and the operation of the service.
There were further concerns over the paediatric-trained nurse staffing at night time not meeting the minimum standards recommended by the Royal College of Paediatrics and Child Health, and some sharps bins in the service were overfilled.
A full report of the inspection will be available on the CQC website: https://www.cqc.org.