Gloucestershire: A&E department 'requires improvement' due to overcrowding and long delays

During the height of the pandemic, 20 ambulances were spotted queueing outside Gloucestershire Royal Hospital's A&E department. Credit: ITV West Country

The A&E department at Gloucestershire Royal Hospital has been ordered to improve by inspectors.

A recent Care Quality Commission (CQC) inspection found overcrowding and long delays, with some patients being treated in corridors during busy periods in the emergency department.

The inspection found patient's “dignity and respect were compromised” and “social distancing was not always possible”. 

Other concerns raised during the inspection included patients not receiving care and treatment promptly, despite effort to keep them safe. 

Patients were also found to experience long delays in handovers from ambulance crews which can"cause harm to patients, lengthen response times and delay ambulances needed in the community."

Sally Hayes, the Deputy Divisional Director of Nursing Quality, told ITV News West Country: "There is no doubt that looking after patients in corridors and holding patients in corridors, is not what we want to be providing.

"And there is no doubt that it is not the best care for them, and when that has happened, and we would like to apologise for that and I would just like to say as you've seen we have now abolished that."

Inside Gloucestershire Royal Hospital's A&E department.

The report also had positive findings. It showed how staff understood how to protect patients from abuse, and kept detailed and comprehensive records of patients’ care and treatment.

It also showed leaders in the department understood priorities and were supportive and caring with patients and staff. 

The unannounced inspection was carried out in March 2021, and the CQC says it was clear the department was under significant pressure because of the pandemic.

One reason for the extra pressure on Gloucester's emergency A&E unit was the decision to close Cheltenham hospital's A&E unit to ambulances during the pandemic.

Professor Mark Pietroni told ITV News West Country: "In June of last year we re-configured to bring all the emergency patients into here.

"We did that as a strategic decision. We learnt from the first Covid surge that we wanted to do more emergency and cancer surgery and as a result our cancer statistics are about the best in the country."

The inspection looks for whether the services are safe, responsive and well-led. 

The watchdog downgraded the ‘overall rating’ for the department from ‘good’ to ‘requires improvement’, as well as the rating for ‘safety’. The rating for ‘responsive’ remains unchanged  as ‘requires improvement’, and the  rating for ‘well-led’ remains ‘good’.

These ratings are specific to the emergency department and do not impact on the overall rating for the whole hospital. 

Cath Campbell, CQC’s Head of Hospital Inspections, said: “During our inspection, it was clear that staff within Gloucestershire Royal Hospital’s emergency department were delivering patient-focused care in incredibly challenging circumstances.

“However, we did have concerns regarding the flow through the emergency department, as unprecedented numbers caused by the Covid-19 pandemic meant that some patients were being treated in corridors in the department. 

“We were assured by the trust’s rapid response to address this issue. We were also aware of the efforts to support the ambulance service in minimising handover times.

“The trust's leadership are aware of the issues we highlighted to them and were working to ensure improvements were in place and thoroughly embedded. We will return to check on the improvements made. In the meantime, we will continue to monitor the service closely to ensure that these improvements are on track.”

Read more: