Gloucestershire CQC inspection highlights urgent care delays

Some delays have been partially blamed on ambulances "stuck" waiting for patients to be admitted to hospital

An inspection of a county's urgent and emergency services found delays were caused by a lack of empty beds and prolonged waiting times.

The Care Quality Commission (CQC) inspected Gloucestershire emergency care services in November and December.

The report found staff worked well in challenging circumstances but the CQC said pressures on workers across the system needed addressing.

Dr Jeremy Welch said: "The system is being stretched and we need to adapt."

Gloucestershire's Clinical Commissioning lead added: "We're very grateful to the CQC for coming in and having a different pair of eyes looking at our systems because we have put a lot of work in.

"We're trying our darnedest to get this to work for patients... but we except it's not working perfectly", he added.

The CQC found the areas NHS 111 service performed well, although staff sickness and increasing calls through the pandemic added pressure

Inspectors visited services across the One Gloucestershire Integrated Care System (ICS), which consists of all healthcare partners in a specific geographical area.

They included the emergency departments at Cheltenham General and Gloucester Royal Hospitals, minor illness and injury units run by Gloucestershire Health and Care NHS Foundation Trust.

'Complicated'

They also inspected both the operations centre and the emergency ambulance service at Southwestern Ambulance Service NHS Foundation Trust, an independent NHS 111 service, and an out of hours service run by Practice Plus Group.

CQC deputy chief inspector for hospitals, Nigel Acheson, said: "We found the system to be complicated. As a result, staff and patients weren't always able to understand which urgent and emergency care service was best suited to their needs.

"This meant people sometimes attended the emergency department when they could have been treated more appropriately elsewhere."

In addition the report touched on adult social care and the possibility of using empty care home beds when hospitals were struggling to cope.

Dr Welch recognised "it's been a blinking tough time in care homes" over the pandemic and credited the relaxing of rules to allow visits but said there are other factors that would need to be considered.

However he added: "We've got enough beds when we map across, it's just getting patients through the hospital and home because home is where they want to be."

'Click or Call First'

In response to the need to strengthen acute and same day services Dr Welch said: "Subsequent to the report we've put in a same day emergency care centre where patients can be admitted directly for rapid testing" then turned around, sorted and discharged.

He also said in response to patients sometimes being confused over where to go for treatment, there was a big push over the winter for the NHS Click or Call First.

The system encourages patients to look at their NHS app, GP practice websites or call their GP surgery before going for care.

The report also found there were often not enough nurses with the right qualifications at Cheltenham hospital.

Dr Welch said changes over the last two years "especially with Covid and the need for red and green Covid hospitals... [meant] we need to do better there".

However, he added: "I can reassure the people of Gloucester and particularly Cheltenham the balance is being looked at to be addressed.