Ysbyty Glan Clwyd: Stroke patients would rather go to England

A new report has been critical of Ysbyty Glan Clwyd A&E

People would rather go to England if they had a stroke than use the A&E at a north Wales hospital, a health watchdog has said.

Inspectors said there was a "clear and significant risk to patient safety" after inspections at the department in Ysbyty Glan Clwyd, Denbighshire.

North Wales Community Health Council's Geoff Ryall-Harvey said it was the "worst situation" they had seen.

Betsi Cadwaladr health board said it was committed to improvements.

The Healthcare Inspectorate Wales (HIW) report said the A&E department required significant improvement after an unannounced three-day inspection in May.

The Welsh government said the report was "extremely concerning", adding the "standard of care falls considerably short of what we expect for patients in Wales".

But officials said improvements had been made and it was safe for people to attend A&E.

Opposition parties said the report was "alarming" and called for the Labour Welsh government to act.

• Health board avoids being put in special measures

Responding to the report, health board chief executive Jo Whitehead apologised to patients "who didn't receive the care they deserve".

Earlier this year vascular services at the north Wales' health board were also designated as needing "significant improvement".

Last week it was announced a second English hospital will take some vascular patients from north Wales, because of that service's fragility.

What's in the report?

The report, published on Monday by HIW, said inspectors found staff who were "working above and beyond in challenging conditions" during a period of "unrelenting demand".

However inspectors said that the health board was not fully compliant with many of the health and care standards, and highlighted significant areas of concern, which could present an immediate risk to the safety of patients.

The report states inspectors found:

• Doctors were left to "come across" high-risk patients instead of being alerted to them

• Patients were not monitored enough - including a suspected stroke patient and one considered a suicide risk

• Used underwear was discover among dirty equipment found in cupboards

• Cupboards containing prescription only medicines, scalpels and needles were left unlocked

• Children were at serious risk of harm as the public could enter the paediatric area unchallenged

• An adult patient was in the paediatric area when a child was receiving care there

• Inspectors found evidence of children leaving unseen or being discharged against medical advice

Inspectors said many staff told them they were unhappy and struggling to cope. They said they did not feel supported by senior managers.

HIW said it was concerned management was unaware of "very serious issues" it found.

Geoff Ryall-Harvey said things had never been worse

Mr Ryall-Harvey said the impact on patients in north Wales was very concerning.

"This is the worst situation we've seen," he said, adding, "People tell us if they have a stroke they're going straight up to Liverpool or Arrowe Park, so there is that reputational damage and the loss of confidence."

One elderly person in hospital, who did not want to be identified, told the BBC they spent 27 hours in A&E sat on a hard chair.

"Glan Clwyd is not fit for purpose," they told a reporter, "What's happening is disgusting."

Alun Jones, chief executive of HIW, said: "The findings within this report are extremely concerning, and we have urged the health board to take immediate action to protect patients from the risks identified.

"The designation has been made to strengthen and accelerate the measures taken to drive timely improvements within the service," he said.

"We will be working with the health board to ensure robust improvements are made in a timely manner, and will consider the timing of any follow up activity, which will need to be evidenced."

Jo Whitehead insisted she was committed to working with staff to see health services improve

Despite apologising to patients, Ms Whitehead insisted she was committed to working with staff to see health services improve.

"The buck does stop with me," she said, "I take these concerns incredibly personally, incredibly seriously, which is why I'm absolutely determined to work through the challenges with our staff."

Ms Whitehead said some patients had "received a standard of care well below what they, and we, expect", and apologised unreservedly.

She said staff were working under immense pressure, and staffing continued to be an issue, but that the health board was committed to recruiting more permanent staff, and she had spoken to staff in the department to discuss how they could be supported to do their jobs more effectively.

"I feel confident that we're putting the right actions in place in order to improve services for north Wales," she said.

"That's what drives me on, the desire to put things right for patients."

Mark Pullin was last seen alive leaving Ysbyty Glan Clwyd A&E in January

The family of Mark Pullin believe HIW's probe into the department was sparked by the 42-year-old's death in January.

Mr Pullin, from Colwyn Bay, left Glan Clwyd's emergency department in the early hours and was not wearing any shoes. His body was found days later after a police appeal.

Ms Whitehead offered "absolutely sincere apologies" to the family for what happened.

"As a consequence of that very unfortunate death we have put steps in place to ensure our discharge arrangements, particularly for certain individuals are really, really robust," she said.

The inquest into Mr Pullin's death is ongoing.

HIW have not confirmed their probe was prompted by Mr Pullin's case.

Welsh Conservative north Wales spokesman Darren Millar said: "It will be deeply alarming to people across the region that the situation at Ysbyty Glan Clwyd still isn't getting things right despite being put into targeted intervention - Labour ministers need to step up and take responsibility for their failings."

Plaid Cymru's healthcare spokesman Rhun ap Iorwerth said the report was "damning" and called for the health board to be reorganised because "I think we have little choice".

Welsh Liberal Democrat leader Jane Dodds said: "It is abundantly clear that the board was taken out of special measures before it was appropriate to do so."

'It is safe for people to go to A&E'

A Welsh government spokesman said the standard of care "falls considerably short of what we expect for patients".

"We took immediate action in June by escalating this service to Targeted Intervention status and commenced an improvement intervention to make immediate changes to ensure that the service is safe," they said.

"We are assured by the health board that many of these actions have now been implemented and that it is safe for people to continue attending the emergency department at Ysbyty Glan Clwyd.

"It must be remembered that the majority of patients who attend this emergency department receive good, safe care."

Former Member of the Senedd Eleanor Burnham, who also served as a member of the community health council, said it was time to stop treating the NHS like a "sacred cow".

"You need far clearer accountability in these places," she BBC Radio Wales Breakfast.