Serious concerns raised about Emergency Department

Only 53.6% of patients to Wye Valley's emergency department were admitted, transferred or discharged within four hours in December

An unannounced inspection of Hereford County Hospital has raised “serious concerns” about safety in its emergency department (ED), according to its managing director.

While a full report has yet to be published by the Care Quality Commission, the series of visits in December has been discussed at a regional meeting of hospital bosses.

“A congested ED is not a safe ED,” Wye Valley NHS Trust's managing director Jane Ives said.

Bosses reported staffing levels had been boosted but noted the trust was currently heavily reliant on expensive agency and temporary staff.

“We’ve obviously responded to those safety issues, partly by increasing our staffing levels, and that is at premium cost,” Ms Ives told a meeting of the Foundation Boards Group.

Citing a higher number of admissions and longer patient stays as factors in the congestion, she informed the meeting last Wednesday: “We’ve gone from pre-Covid to now, from probably having a 20-bed deficit to probably something that’s nearer a 60-bed deficit on a day-to-day basis."

To ease pressure, the trust is looking to expand its "virtual ward" service, which allows patients to get care at home, rather than in a hospital bed, as well as speed up the discharge of medically fit patients.

Wye Valley’s chief nursing officer Lucy Flanagan said the trust was maintaining safe staffing levels, “but not at best value for money and certainly not at best quality”, and was heavily reliant on agency and temporary staff.

Although the trust currently had a low number of vacancies for registered nurses and healthcare support workers, Ms Flanagan said this was because budgets did not match the reality of the hospital.

“For example, we’re having to put an additional 28 whole-time equivalents into our emergency department to keep the patients safe," she said.

Despite being open constantly for two years, another 16-bed ward, Gilwern, was said to be unfunded by the trust’s budget.

The trust’s management board is now looking to increase the workforce to reduce reliance on agency workers.

A summit of clinicians and managers on Monday discussed how developments since the Covid pandemic had left hospital capacity more stretched.

At Wye Valley's last full inspection in 2020, it was rated as "requires improvement". A new report based on the latest probe is expected in the next few weeks.