North Wales A&E department rated 'chaotic' with 'excessive' waiting times and patients leaving unnoticed - North Wales Live

2022-05-28 12:20:14 By : Mr. Peter Wang

Critics have called for reform of the North Wales health board after a damming report by Health Inspectorate Wales

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A hospital’s emergency department (ED) has been has been rated an area of extreme concern by a health watchdog. Health Inspectorate Wales (HIW) has designated Ysbyty Glan Clwyd's A&E as a “Service Requiring Significant Improvement”, prompting calls for the Welsh Government to take immediate action.

HIW investigations revealed a catalogue of problems not acted upon by Betsi Cadwaladr University Health Board since they were first identified. A&E patient flows were said to be “chaotic and ineffective” , and waiting times were described as “excessive”.

Areas of the department was found to be “dusty and/or soiled”, and the screening of vulnerable patients needed to be improved. Management of waiting areas was poor, resulting in high risk patients leaving unnoticed as well as “confusion and delays” in treatments.

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In one case a patient should have been seen within 10 minutes but waited more than six hours to see a doctor. In others, patients waited more than 12 hours to see specialists. According to HIW, the situation was so disorganised that staff were “not always able to identify where high risk patients were located within the department”.

These findings were reported following a visit to the Bodelwyddan hospital in Denbighshire on March 8. An unannounced inspection took place on May 3-5 which found areas where the health board’s actions had “not led to improvement” since previous visits.

“Consequently, having considered the findings and evidence gathered since January 2022, HIW has determined that the health board has not been able to demonstrate sufficient progress against several key areas of concern relating to patient safety and quality of care,” said HIW.

The health board today issued a statement apologising to patients. It pledged to work with HIW to “put things right.”

But Llŷr Gruffydd, Plaid Cymru’s North Wales MS, said the HIW report showed the region’s health services were in need of immediate reform. “Time’s up for Betsi,” he said.

Claiming the health board was “unfit for purpose”, he said it was “too big and cumbersome” to be effective. He added: “For too long, we’ve been waiting for improvements that never arrive. For too long, we’ve been made promises that it’s all in hand, when it’s now clear the opposite is true.

“The time has come for the Welsh Government to start a wider conversation about reforming health services in the north of Wales. They say ‘if it ain’t broke, don’t fix it’ but it’s clear that it is broken, and it does need fixing.”

Had a poor experience at Glan Clwyd? Convinced the health board will "put things right"? Have your say in the comments below.

The HIW report from March 8, published today, identifies numerous areas of concern. It found that patients with infections, mental health problems and even significant head injuries were “not subject to any consistent or ongoing checks, or monitoring of their condition”.

Bathroom sanitary fixtures were “not in a good state of repair and clean linen was being stored on top of a cleaning trolley. Some single-use equipment being put back into drawers.

Monitoring of patients was often inadequate, including those with “suicidal ideations”. The report said: “In some cases these patients left the department unnoticed and in some cases no attempts were made to locate the patient.

“Patients presenting with mental health issues and self-harm were not routinely assessed for their risk of further harm. This had resulted in several patients leaving the department without being seen and in some cases returning after further self harming.

“Through reviews of patient records we identified cases where patients who were vulnerable were placed in areas where they could leave, unseen. In some cases this had occurred and staff were not aware of the absence for long periods. These cases included patients with significant mental health issues and children.”

Concerns had been raised but not acted upon by senior management, said HIW. Jo Whitehead, Betsi’s chief executive, said the report was “extremely disappointing to read” but she accepted it “in its entirety”.

“It is clear from this report, and HIW’s subsequent visit, that patients received a standard of care well below what they, and we, expect,” she said. “We have fallen short of those expectations and we must, and we will, do better.

“On behalf of the health board I apologise to those patients who did not receive the care they deserve. We take our duty of care to patients very seriously and we are working with HIW to put things right.”

Ms Whitehead said Betsi’s senior leaders have already implemented a more robust oversight of the hospital's emergency department. Different models of care, designed to ensure earlier assessment of patients, have also been introduced.

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She added: “Emergency Departments are for people who are seriously ill or injured with life-threatening injuries and illnesses, which need immediate action and we encourage you to attend if you need this support. We treat hundreds of thousands of patients every year, safely.

“We continue to be extremely stretched in our emergency departments across North Wales, which together with staff shortages puts a greater stress on those who are working, often having to cover extra shifts so our departments can function. This situation is compounded because we are seeing more people who are very unwell on arrival at our emergency departments.”

Clwyd West MS Darren Millar called on the Welsh Government to take immediate action. He said Betsi’s inability to address previous patient safety concerns was “appalling”.

He added: “Today’s news is deeply concerning, but sadly not shocking given the correspondence in my inbox in recent months. The Health Board clearly wasn’t ready for special measures to be withdrawn prior to the last Senedd elections and today’s announcement suggests that the Health Minister’s decision was purely political and not based on evidence.”

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