‘Urgent improvement’ needed at Welsh A&E where some patients have had 15-hour waits

Urgent improvements are being called for at a new south Wales hospital’s emergency department, where some patients have been waiting in the back of ambulances for over 15 hours.

A recent Healthcare Inspectorate Wales (HIW) inspection highlighted the need for “urgent improvement” in the emergency department at The Grange Hospital, Cwmbran.

The HIW report said that Aneurin Bevan University Health Board did not have adequate arrangements in place within the department to support the delivery of safe healthcare. 

A number of issues requiring immediate assurance were identified by the inspection team. 

These include the risk of cross-contamination in an area known as the ‘Covid corridor’, resuscitation equipment was not being checked daily, out-of-date medicines were found and there was a lack of security around substances which could be harmful to the patients.

Inspectors said staff were striving to deliver good quality, safe and effective care to patients, within a busy challenging unit.

Patients told inspectors they were happy with the way that staff interacted with them and were complimentary about the dedication shown by staff and the care provided, but many patients were critical of the department’s waiting times.

The HIW report said: “Comments from staff showed that they could not always deliver care to the standard they wanted due to the increasing pressure and demand on the department.

“Our findings did highlight management and leadership was good, with staff stating they felt supported. Management was visible within the department, including the nurse in charge who was identifiable and accessible.”

The HIW said improvements were needed to the “small and cramped” waiting room, with some patients waiting on uncomfortable chairs, and in the back of ambulances, for over 15 hours.

“Until the flow of patients into and through the department can be improved, the health board will find it challenging to address a number of our concerns,” the HIW said.

“In addition to the areas which required immediate action be taken in order to keep patients safe, HIW has urged the health board to carefully consider all findings from this report and undertake action to reduce the potential for significant harm to patients and to embed all improvements into practice.”

‘Extremely concerning’

Chief Executive of HIW, Alun Jones said: “Our inspection findings are extremely concerning, and we have urged the health board to take action to improve the processes and systems in place within the emergency department so that patients receive safe, timely and effective care. 

“I hope this report will accelerate the measures taken to drive forward timely improvements. We will be working closely with the health board to ensure robust improvements are made and evidenced.”

Aneurin Bevan health board said it welcomed the findings.

The new hospital – which received over £360m in Welsh Government funding – opened in late 2020, to provide emergency and urgent care, bringing together services previously provided at the Royal Gwent Hospital in Newport and Nevill Hall Hospital in Abergavenny.