Emergency department 'stretched and overcrowded'

"Enormous pressure" has been caused by staff shortages and overcrowding at an urgent care and emergency department, according to a new report.

As a result, the Care Quality Commission (CQC) has held the rating for Royal United Hospital (RUH) in Bath at "requires improvement".

In a report based on an inspection in October, the CQC said it found three breaches of regulations related to safe care and treatment, staffing, and management, particularly overnight.

A spokesperson for the RUH said since the "unannounced" inspection, it has made progress on improvements, including having more decision making staff available overnight.

Catherine Campbell, CQC deputy director of hospitals for secondary and specialist care in the South-West, said the department was "under enormous and unsustainable pressure, but staff were still working as hard as they could under the circumstances, to try and provide safe care and treatment to people."

She added: "The department didn't have enough senior doctors overnight, falling below national guidelines, and nursing vacancy and sickness rates were high.

"This left gaps in cover that leaders struggled to fill, and when agency or bank staff were brought in, they didn't always have the specialist skills needed to manage complex emergencies which could put people at risk."

Campbell also highlighted issues with overcrowding, clutter and mental health patients.

A spokesperson for the RUH said its emergency department now has more oversight of its access points to keep them unobstructed, and it is looking at its working practices.

They also added the department has faced its highest demand since the inspection, with footfall increases of 13% and ambulance demand up 25%.

"We have been working hard to respond to these new working practices alongside South West Ambulance Service Foundation Trust to make sure that it does not result in overcrowding in the department and we are committed to putting the right measures in place to avoid corridor care in the hospital during the course of next Winter."

The RUH spokesperson said it believes it will be one of the most improved trusts in the country against its four-hour emergency department target, and is going to be building a new urgent treatment centre this year and rebuilding A&E over the next three.

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