Damning report highlights ‘risks to patients’ at Ysbyty Glan Clwyd’s Emergency Department

A damning Healthcare Inspectorate Wales report has identified “risks to patients” and “significant concerns” at Ysbyty Glan Clwyd’s Emergency Department in Rhyl.

The report follows an inspection in May which identified that Betsi Cadwaladr University Health Board did not have adequate arrangements to support the delivery of safe healthcare in the department.

The inspection in May was undertaken to follow up significant concerns identified during a previous quality check undertaken in March 2022.

As a result, HIW designated the emergency department in Ysbyty Glan Clwyd as a Service Requiring Significant Improvement (SRSI) on 9 May 2022.

The May inspection also identified several additional areas of concern relating to patient safety around the effectiveness of arrangements for assessing, monitoring, observing, and escalating unwell or deteriorating patients.

Nursing documentation

HIW also noted that the quality of the nursing documentation fell far short of the required standard and found evidence of poor management of health and safety risks, such as unsecure access and exit from the paediatric area. Infection prevention and control procedures were also insufficient.

The quality of management and leadership was described as “not sufficiently focused and robust” and the report expressed concern that “arrangements for oversight had not enabled the health board to pick up on the issues identified by HIW during the inspection”.

Chief Executive of HIW, Alun Jones 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.

“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.”

Standard of care

Jo Whitehead, chief executive of Betsi Cadwaladr University Health Board said: “It is clear from this report, and HIW’s subsequent visit, patients received a standard of care well below what they, and we, expect.

“We have fallen short of those expectations, and we must, and we will, do better.

“On behalf of the health board I apologise to those patients who did not receive the care they deserve.

“I can assure the public, senior leaders already have more robust oversight of the Emergency Department at Glan Clwyd Hospital, including different models of care which are designed to ensure earlier assessment of patients.

“Emergency Departments are for people who are seriously ill or injured with life-threatening injuries and illnesses, which need immediate action and we encourage you to attend if you need this support. We treat hundreds of thousands of patients every year, safely.

“We take our duty of care to patients very seriously and we are working with HIW to put things right.”

Restructuring

Responding to the report, Plaid Cymru has reiterated its calls for a completer restructuring of health services in the north of Wales.

Plaid’s spokesperson for Health and Social Care, Rhun ap Iorwerth MS, said: ““Another week, another damning report, and more concerns for patients’ safety.

“When will this end?

“This report again speaks of patients being put at risk and staff ‘working above and beyond in challenging conditions”.

“I have little faith in Welsh Government’s ‘targeted interventions’, and once again I call on the Health Minister to look at how starting again with new health structures in the north could provide the fresh start patients and staff need.

“It’s not because I particularly want a health reorganisation but that I think we have little choice.”

Welsh Liberal Democrat Leader Jane Dodds said: “This the latest in a number of alarming reports regarding Betsi Cadwaladr Health Board. It is abundantly clear that the board was taken out of special measures before it was appropriate to do so.

“Patients and staff must now get the reassurances needed from Labour that things are going to change. The Welsh Government must work with the health board to take significant action immediately.”