'Inadequate': Inspectors find 'significant concerns' at Princess Alexandra Hospital A&E

Inspectors visited A&E at the Princess Alexandra Hospital on 14 February Credit: ITV Anglia

The accident and emergency department at Harlow's Princess Alexandra Hospital has been downgraded to an 'inadequate' rating following an inspection.

Officials from the Care Quality Commission (CQC) found the department was understaffed and waiting times were too long - with one patient waiting over 17 hours to be admitted when the inspection took place on 14 February.

The report also found staff not following coronavirus prevention methods, such as changing PPE when moving between 'red' areas where Covid-19 positive patients were being held and 'amber' areas where other patients were.

Inspectors were informed that there were not enough staff to keep patients safe.

Bernadette Hanney, CQC Head of Hospital Inspection

Bernadette Hanney, CQC’s Head of Hospital Inspection, said: "When inspectors visited the urgent and emergency service at The Princess Alexandra Hospital NHS Trust, it was clear that staff supported one another to deliver patient focused care in challenging circumstances.

"However, there were areas where significant concerns were found. Inspectors were informed that there were not enough staff to keep patients safe and the department was heavily reliant on bank and agency staff. 

"People could not always access the service promptly. Waiting times from referral to treatment and arrangements to admit, treat and discharge patients were worse than national standards.

"Inspectors reported their findings to the trust leadership and asked them to send us a report outlining what action they will take to meet these requirements. We are pleased that since the inspection, the trust has already started to make positive changes and improvements across the service. We will continue to monitor the service to ensure the necessary improvements are made."

One of the key concerns highlighted in the report was the failure to properly risk assess patients in A&E.

In one instance, staff had not recorded the description of a suicidal patient in case they absconded.

The treatment of another person with mental ill health was also highlighted. The patient was helped to shower by hospital security staff.

"[The hospital] told us the security staff had received safeguarding training, had disclosure and barring service (DBS) checks and had not entered the shower with the patient," the report said.

However, Ms Hanney said this incident "was particularly concerning because no risk assessments had been completed and there were no assurances that they were trained to support a patient in this way."

What do the Princess Alexandra Hospital have to say?

Lance McCarthy, chief executive of The Princess Alexandra Hospital NHS Trust said: "Our urgent and emergency teams continually strive to provide excellent care for patients, and they have already put in place improvements and additional support following the inspection.

"Whilst we are pleased the CQC noted our team were focused on patients’ needs and that there was a stable leadership team in place, we know there is more to do and we are committed to continuing our work to better support patients."

The inspectors saw staff crossing between Covid-19 and non-Covid-19 areas of the department several times during their day in A&E.

On one occasion, someone pushing a refreshments trolley brought it from a 'red' area which had patients who had tested positive for coronavirus into the 'amber' section without wiping it down.

However, the inspectors did find that all staff were wearing their PPE correctly, regularly washed their hands and sanitised equipment and maintained social distancing.

The CQC also highlighted consistent understaffing in A&E at the Princess Alexandra Hospital. It found that on average only 80% of nursing shifts were filled between November 2020 and January 2021.

The trust said this was due to increased levels of staff sickness and shielding.

The CQC have told the hospital trust several improvements which should be made, some of which are legally binding as part of a section 29A warning notice served along with the report.