Norfolk and Waveney: Staff shortages causing delays in emergency care

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Row of ambulances outside the Royal London Hospital, January 2021Image source, EPA
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A CQC report said departments were well-run but patients were facing waits of more than 12 hours

Staff shortages have led to long delays in Norfolk emergency departments, inspectors have found.

The Care Quality Commission (CQC) has reviewed urgent and emergency care, GP surgeries, adult social care and the 111 service in Norfolk and Waveney.

It found some patients waiting 12 hours for treatment and said work was needed "to alleviate significant pressure".

The Norfolk and Waveney health and care system said it welcomed "the opportunity to make improvements".

Image source, QEH
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The Queen Elizabeth Hospital in King's Lynn was inspected as part of the review

The CQC inspected urgent and emergency care and medical services run by James Paget University Hospitals, the Queen Elizabeth Hospital King's Lynn and Norfolk and Norwich University Hospitals NHS Foundation Trust.

Mandy Williams, CQC director of integrated care, inequalities and improvement, said the departments were "well-run" despite delays.

She said inspectors found "a high number of people waited more than 12 hours for assessment and treatment".

This, she said, led to "overcrowded departments, delayed ambulance handovers and risk to patients".

Ms Williams said staff shortages in other services were "significant" factors in causing the problems found.

"People couldn't always access their GP, dentist or NHS 111 service when they needed - resulting in unnecessary 999 call or visits to hospital when minor ailments became unmanageable," she said.

"We also found staff shortages in adult social care meant people remained in hospital when they should have been discharged to respite services."

On the day of the inspection at the Norfolk and Norwich University Hospital, there were 134 patients "with no criteria to reside", the report said.

More than half of those patients were "waiting for onward care packages or repatriation to another hospital setting", it said.

Ms Williams said the delay in discharging patients meant there were "insufficient beds" in hospitals.

Image source, James Horne/BlueSkyUAV
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The Norfolk and Norwich University Hospital was experiencing pressures on bed capacity, the report said

Ms Williams highlighted that leaders had developed strategies to help alleviate pressure, including discharging patients to a hotel if they were fit to leave hospital but still required care.

The report said it found people were "safe and generally well cared for" at the hotel.

There was also a system which immediately referred patients to a GP if they attended hospital with an issue which could be dealt with by a practitioner.

A spokesperson for the Norfolk and Waveney Clinical Commissioning Group said the review took place when there were "considerable and on-going pressures" due to Covid and workforce challenges.

"Our priority is ensuring that patients have access to safe and high-quality services wherever they live, and we welcome the opportunity to make improvements to how we approach these challenges" they said.

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