A Healthcare Inspectorate Wales inspection of the emergency department finds that high demand and poor patient flow through the hospital is impacting the department.
During an unannounced inspection, Healthcare Inspectorate Wales (HIW) identified sustained systemic challenges which impact Wrexham Maelor’s Emergency Department. These include high demand and poor patient flow through the hospital due to delays in discharging patients.
“Like many NHS Emergency Departments across Wales, Wrexham Maelor is under considerable pressure. Addressing systemic issues around patient flow and care delivery is essential to ensure safe and timely care,” said Alun Jones, chief executive of Healthcare Inspectorate Wales.
Inspectors acknowledged that staff were working under challenging conditions but it said that delays in patient discharge resulted in some patients spending more than 36 hours in the department.
Calm waiting area
The waiting area and other areas of the emergency department were found to be relatively calm, despite the high number of patients being accommodated. Patients with urgent and high-risk conditions were quickly escalated and moved to the appropriate treatment areas. Specialist support was effective, with doctors responding promptly to assessments. Delays were noted in offloading patients from ambulances; however, these delays are being managed with appropriate escalation procedures in place.
Inspectors found, however, that not all patients were triaged within the recommended 15-minute window upon arrival, and there were instances where repeat patient observations were not consistently carried out or recorded.
When reviewing patient records, the report says although most were electronic, the documentation completed by specialist doctors was still in paper format, making it difficult to get a full overview of patient assessments and treatments.
Wrexham Maelor Hospital is managed by Betsi Cadwaladr University Health Board.
