Despite some improvements, Healthcare Inspectorate Wales found that ongoing challenges remain at the hospital including the management of the hospital’s surge areas.
During a three-day inspection of the Emergency Department at Morriston Hospital in Swansea, Healthcare Inspectorate Wales (HIW) found that ongoing challenges remain.
The independent inspectorate and regulator of healthcare in Wales identified several areas requiring immediate improvement, including the management of the hospital’s surge areas, which were used to accommodate an unexpected increase in patients.
This included overcrowding in non-bay areas where patients had no access to call bells, which posed safety risks, as well as delays in patient assessments. Inspectors were not assured that the health board had effective processes in place to manage risks, allocate staff appropriately, and conduct risk assessments in these areas.
Immediate improvement was also needed regarding the safe management and administration of medication. Inspectors found medication and fluids stored in unlocked drawers, incomplete temperature and stock checks, and a lack of quiet, clean spaces for nurses to prepare medication without interruption.
“There are mounting pressures on NHS services and Morriston Hospital, like all hospitals across Wales, continues to face extraordinary challenges due to increased demand,” said Alun Jones, chief executive of Healthcare Inspectorate Wales.
Challenges remain
The inspectors found that efforts have been made to improve patient flow, including the introduction of the Older Persons Assessment Unit (OPAU) and direct GP referrals, which help reduce pressure on the emergency department.
Delays in discharging patients from other areas of the hospital, however, continue to impact care and contribute to overcrowding.
While it was noted that Infection Prevention and Control (IPC) audits were up to date, inspectors observed inconsistent hand hygiene practices and reminders were given to doctors to adhere to policies.
Effective communication among staff within the departments, particularly during handovers, was noted as a positive practice. Inspectors noted the department’s leadership team was continually striving to improve the service despite the challenging conditions.
When asked, the feedback from staff was generally negative, particularly around staffing levels and concerns regarding patient safety and an unsafe care environment.
“While challenges remain, the health board’s improvements, such as the Older Persons Assessment Unit and direct GP referrals, are steps in the right direction to improve patient flow and waiting times,” said Jones.
