NHS: Treatment and care is 'compromised' in Heath Hospital's A&E due to extreme demand

'The system is constrained and people are part of that compromise, their treatment and care is compromised', Dr Katja Empson tells ITV News

An emergency consultant at Wales' largest hospital has admitted that patient care is being "compromised" by unprecedented demand and delays in discharging patients.

Dr Katja Empson has worked at the University Hospital of Wales' emergency unit for 14 years, and told ITV News she has never seen it this challenged.

"Things are certainly worse than I've known them, the experience that people are having through the system, the delays getting to hospital and then the delays getting back out of hospital, they are really worse than they used to be," Dr Empson explained.

"There [are] patients sitting in chairs in corners of the department where we really shouldn't be asking people to wait.

"When every single cubicle and nook and cranny of the department has got a patient sitting in it, your capacity to manage all of those patients safely, with compassion and kindness becomes challenging, particularly towards the end of a long clinical shift."

Dr Katja Empson said staff are constantly having to balance risk across the emergency unit.

Dr Empson assured that the sickest patients do get through the system, but others will face long delays before receiving treatment.

On the busiest days, around 550 patients attend the emergency department in the Heath area of Cardiff over a 24-hour period, but many of those people will face extremely long waits.

In November, less than 64% of patients attending the University Hospital of Wales' emergency department were seen within the target time of four hours.

A similar picture is painted across Wales, with just 67.3% of patients spending less than four hours, according to Welsh Government data.

Percentage of patients who spend less than four hours in an emergency department, November 2022

  • 48.6% - Ysbyty Glan Clwyd, Bodelwyddan

  • 58.7% - Withybush General Hospital, Haverfordwest

  • 54.1% - Morriston Hospital, Swansea

  • 53.8% - Prince Charles Hospital, Merthyr Tydfil

  • 53.7% - The Grange University Hospital, Cwmbran

The Welsh Government said unprecedented demand on the NHS has been exacerbated by high levels of flu and Covid.

"We plan for winter all year round and this year have invested in new ambulance staff, transforming emergency departments and improving the flow through hospitals, and we have continued to put in place actions to respond to the pressures," a spokesperson said.

"Our hardworking NHS staff continue to provide high quality care for thousands of people every day.

"Everyone can help support the health service by going for their vaccinations when invited and considering carefully where to go for care. Anyone with non-life-threatening conditions is advised to use the NHS Wales 111 website in the first instance."

Ambulance crews are facing long waits outside hospitals across Wales before handing over their patients.

In Cardiff, innovations are taking place to improve delays across the system.

One of the greatest challenges in the NHS is ambulance handover delays, which see crews waiting to take patients into hospitals for sometimes their entire shift.

But according to figures from the Welsh Ambulance Service, in December, handover delays at the University Hospital of Wales were reduced by almost a third compared to this time last year.

Despite this, the hospital is still facing huge challenges when it comes to bed shortages.

On average, it looks after around 350 patients who are medically fit for discharge a week - many of whom are waiting for a package of care to go home.

But there aren't enough social care workers to meet increasing demand, due to longstanding issues in recruiting and retaining staff coupled with an ageing population.

In October, a dedicated department opened at the University Hospital of Wales for patients who no longer need acute treatment, but still require support before being discharged.

Judith Hill, head of integrated care at Cardiff and Vale University Health Board, said: "This ward is about trying to organise appropriate discharge planning who are clinically optimised, which means that their acute episode of care has been completed but their needs remain complex.

"We do currently have a large number of people who are clinically optimised, but that doesn't mean to say that they don't need to be in the hospital environment.

"They do need to be somewhere we can take that full, comprehensive, multiagency assessment of their needs so we can support them to go home and try our best to prevent any readmission.

"We've admitted approximately 112 patients into the unit since we opened in October and we've managed to safely discharge 90 people, so that's a large number of people that we've managed to move through the system."

Patients who are medically fit for discharge but still require support before they go home are being moved onto a dedicated ward.

The average length of stay for patients who are medically fit for discharge has been reduced by almost two weeks with the unit, from 48 to 36 days.

Jane Andrew, senior nurse, said: "If people stay in hospital we decondition them, so in a hospital ward in a busy environment we don't have the spaces for mobility, so [they experience] muscle wastage and it just leads to them not going home.

"Could you imagine coming into hospital and never seeing your house again? So the whole opportunity of this ward is to optimise them and hopefully get them to where they'd like to be which is predominantly home."