Safety fears remain after hospital A&E inspection

Medway Maritime Hospital in Gillingham has been re-rated "requires improvement" by the Care Quality Commission

Concerns remain about patients' safety, dignity and how care is managed during busy periods at a hospital emergency department in Kent, inspectors have said.

The Care Quality Commission (CQC) has re-rated A&E at Medway Maritime Hospital in Gillingham as "requires improvement" following its visit in April.

The report did find though that the requirements of a warning notice issued last year had now been met.

Jonathan Wade, interim chief executive of Medway NHS Foundation Trust, said: "We strive to ensure that everyone feels safe in our care and has a positive experience but we acknowledge that despite the improvements recognised by the CQC, too often this is still not the case."

The CQC re-rated the emergency department as "requires improvement" for being effective, caring and responsive.

The rating for being safe was upgraded from "inadequate" to "requires improvement".

The department was re-rated as "good" for being well-led.

The service remains in breach of two legal regulations relating to safe care and treatment, and dignity and respect.

Inspectors have asked the trust for an action plan in response to the concerns found.

Roger James, CQC deputy director of operations in Kent and Medway, said: "We found a service under significant pressure, with staff who weren't always able to provide patients with timely support, treatment, dignity and respect.

"Staff told us this was due to persistent flow and capacity challenges."

The emergency department at Medway Maritime was re-inspected in April

The CQC spoke to more than 50 people during the inspection, and some told them their experience had been "deeply unsatisfactory" due to "excessive noise, limited access to staff, and being cared for in unsuitable spaces".

Inspectors found the department lacked sufficient senior consultant cover, falling short of national staffing guidance.

Staff did not consistently record or review people's pain levels, resulting in some individuals remaining in discomfort.

The department performed strongly in ambulance handovers, keeping delays over 30 minutes to a minimum and allowing ambulances to return to the community more quickly.

The hospital trust apologised to patients and said it had recruited more emergency department doctors and nurses since the inspection.

A spokesperson said: "We are determined to further improve services so that people are treated sooner, and consistently cared for in a compassionate and dignified way.

"Expanding our virtual ward is already helping people leave hospital sooner, and means that some do not need to come into hospital at all."