‘Systemic issues’ within The Grange University Hospital, new report finds

A report from a recent inspection of The Grange University Hospital in Cwmbran found persistent systemic issues, despite some improvements.

Healthcare Inspectorate Wales (HIW) carried out an unannounced inspection of the Emergency Department (ED) at The Grange University Hospital, run by Aneurin Bevan University Health Board, in October.

The two-day inspection identified ongoing systemic challenges affecting the consistent delivery of safe care.

Inspectors reported concerns about insufficient staff oversight in waiting areas, delays in completing risk assessments, and instances where patients did not receive timely pain relief.

They added: “It was disappointing to find that overcrowding in the waiting room and reception area continues to compromise patient privacy, dignity, and access to timely care. This was compounded by delays in patient flow, largely driven by system-wide discharge challenges that have a knock-on effect on the department.”

HIW have asked for immediate improvements to be made in relation to risk assessments, medicine management, and equipment checks.

The report emphasised persistent systemic pressures, with delays in discharging up to 400 patients at the time of inspection due to high escalation status.

Renovation work on the department’s waiting area is progressing but will not be completed until spring 2025, delaying any immediate relief.

Positive changes

The report did note some positive progress since the department’s previous inspection in 2022.

These include the introduction of an electronic triage system to improve the efficiency of patient triage processes, as well as the ongoing construction of an extended waiting area, with hopes to alleviate overcrowding and improve staff visibility.

Inspectors stated that while nurse staffing levels remain under pressure, they have stabilised compared to the previous inspection, with less reliance on agency staff and improved retention.

They noted the impact of enhanced training and support initiatives, including a dedicated practice development nurse.

Committed staff

Inspectors commended staff for their professionalism, compassion, and commitment to delivering care under challenging conditions.

They concluded: “The department remains under pressure, and systemic issues within the health board and the wider NHS continue to impact the consistent delivery of timely care.”

Alun Jones, Chief Executive of Healthcare Inspectorate Wales, said:”This inspection highlights both the dedication of staff working under immense pressure and the significant challenges that remain in delivering safe, timely, and dignified care. We are encouraged by the progress the department is making, but further improvements are urgently needed to address systemic issues affecting patient flow and care delivery.”

“HIW will continue to work closely with the health board to ensure the necessary changes are implemented, so that patients receive the high-quality care they deserve.”