In May, the emergency department was designated as a Service Requiring Significant Improvement. An August follow-up has not calmed concerns. 

Healthcare Inspectorate Wales (HIW) has published an uninspiring final report following an unannounced inspection of the Emergency Department at Ysbyty Glan Clwyd, in Denbighshire earlier this year. 

As Healthcare Today reported at the time, the inspection in May found an emergency department operating under sustained and significant pressure. During the inspection, HIW identified several immediate assurance concerns that required urgent action by the health board. These related to waiting area safety, paediatric emergency care, medicines and equipment management, and safeguarding oversight.

Since then, HIW said that an exceptionally high number of patients, relatives and carers shared their experiences, and it received more than 660 survey responses. Feedback highlighted long waiting times, overcrowding and challenges relating to privacy and dignity, while also recognising the compassion and professionalism of staff.

“People attending emergency departments should be able to expect safe, timely and dignified care, particularly when they are at their most vulnerable. While we recognise the significant pressures facing urgent and emergency care services, this inspection identified serious concerns about patient safety, patient flow, leadership, governance and the effectiveness of the arrangements in place to identify, manage and reduce risks to patients and staff,” said HIW’s chief executive Alun Jones. 

Challenges remain

Following the inspection, HIW has designated the department as a Service Requiring Significant Improvement (SRSI), the highest level of escalation available under HIW’s Service of Concern process. The department was previously subject to SRSI arrangements between May 2022 and August 2024. This latest inspection found that several longstanding concerns remained evident and that improvements made during the previous period of escalation had not been sustained.

A follow-up visit to the Emergency Department took place at the end of August to check progress on the immediate concerns identified during the original inspection. 

Inspectors found improvements in staff wellbeing and engagement, patient flow, safety huddles, paediatric governance, security, and the management of medicines and equipment. However, challenges remain in waiting-room oversight, reducing delays in gaining specialist input following medical and surgical referrals, and ensuring recent improvements can be sustained.

HIW said that enhanced monitoring and follow-up activity will focus not simply on whether actions have been completed, but on whether they are delivering measurable improvements, reducing risk and making a sustained difference to the experience of patients and staff. HIW will continue this enhanced oversight, it said, until it is assured that the required improvements are effective, embedded and sustained.