by Hallum Cowell
A recent report by Healthcare Inspectorate Wales (HIW) has reported serious issues with Heath Hospital following an unannounced inspection during the period March 25th-27th. Heath Hospital is not only the largest hospital in Wales, but it is also where Cardiff University teaches its medical students.
What did the report find?
The HIW report was conducted after concerns were raised by the South Glamorgan Community Health Council (CHC) regarding patient care and the day-to-day running of the hospital. The CHC previously performed their own unannounced assessment of the Assessment Unit (AU) in September 2018 and, in light of their assessment, the CHC cited concerns around “poor patient experience” and a “lack of care and dignity” and worried that these issues ran deep enough to affect the clinical care and treatment provided to hospital patients.
The HIW report points to the lounge area of the AU as a particular source of concern. The report states that “patients were sitting in chairs within the lounge area of the AU for unacceptable and prolonged periods of time with many in excess of 20 hours”. The blame for this poor patient care is directed towards a lack of staff, resulting in many shifts being understaffed and at breaking point.
There are currently a number of vacant positions at the hospital which the report argues is also contributing to the poor quality of care. For example, the report states that, “Monday to Friday, one registered nurse works a twilight shift and runs between both the Medical Emergency Ambulatory Care Unit (MEACU) and AU.” The MEACU staff also commented that the amount of staff on duty in the unit was “not always sufficient to meet the needs of the patients”.
Stress has also become an issue amongst staff at Heath Hospital, according to the report which records medical staff stating that their job drives them to tears both on shift and at home. This arguably seems to be linked to the staffing issue with staff members currently having to cover more ground than they would if there were more staff employed.
However, even considering these issues, the report states that “we saw staff being kind and compassionate to patients, and treating patients with respect, courtesy and politeness at all times” and that teamwork was strong amongst the staff.
The HIW assessment also concluded that the ambulance crews are under a significant amount of pressure too. There are reports of patients being kept in ambulances for prolonged periods of time due to the lack of available beds in the hospital. On one occasion, “a patient who was suffering with a stroke was on the ambulance for so long that they did not receive timely treatment for the stroke”.
Patients stuck in ambulances also leads to other issues arising. It is reported that patients have been unable to use the bathroom and that it has been harder for staff to feed those waiting for beds. In some cases, “the ambulance crew would obtain sandwiches from a refrigerator in AU and also obtain drinks for them whenever possible” because the patient was not yet able to receive food from the hospital because they could not be provided with a bed.
Gair Rhydd contacted the Cardiff and Vale University Health Board for a response to the HIW report but did not receive a comment.
What recommendations have been made?
In light of these findings, HIW have made a number of recommendations in an effort to prompt Heath Hospital to improve the quality of care it provides to patients. It has been recommended that staffing numbers are increased and it is reported that Heath Hospital aims to see 26 vacancies filled by March 2020. Additionally, four recliner chairs have been placed in the AU lounge for more vulnerable patients who are left waiting in the lounge for a prolonged period of time.
Moreover, additional recommendations include improving the recording and keeping of patient data, improving efforts to ensure patient dignity in the lounge area and an overhaul of emergency unit staff and ambulance crews. The HIW request that Heath Hospital takes immediate action to remedy these issues.