Immediate Improvements Ordered at Welsh A&E Following Inspection
Inspectors have identified significant patient safety concerns at a Welsh hospital, prompting the need for immediate improvements. Healthcare Inspectorate Wales (HIW) conducted an unannounced inspection of the emergency department (ED) at Morriston Hospital in Swansea, managed by Swansea Bay University Health Board. During the three-day inspection in November 2024, inspectors found staff working diligently under challenging and overcrowded conditions, leading to concerns about patient safety.
Patients reported frustration with long waiting times, a result of poor patient flow within the hospital. The inspection highlighted the urgent need for improvements in managing surge areas, which were utilised to accommodate an unforeseen influx of patients. Issues such as overcrowding in non-bay areas without access to call bells, delays in patient assessments, and inadequate medication management were flagged as areas requiring immediate attention.
Efforts to enhance patient flow, including the introduction of the older persons assessment unit (OPAU) and direct GP referrals, have been noted positively. However, delays in discharging patients from other hospital areas continue to impact care and contribute to overcrowding. While infection prevention and control (IPC) audits were up to date, inspectors observed inconsistencies in hand hygiene practices, highlighting the necessity for reinforcing safety measures for patients and staff.
Effective communication among staff, particularly during handovers, was commended as a positive practice. The hospital’s leadership team was recognised for their continuous efforts to improve services amidst challenging circumstances. Nevertheless, staff feedback indicated concerns about staffing levels, patient safety, and an unsafe care environment, urging the health board to address these issues promptly.
Chief executive of Healthcare Inspectorate Wales, Alun Jones, acknowledged the mounting pressures on NHS services, emphasising the importance of ongoing improvements to enhance patient flow and waiting times. Swansea Bay University Health Board responded, acknowledging the report’s fair review of the ED’s challenges and reaffirming their commitment to prioritising urgent and emergency care improvements.
The health board outlined a three-pronged approach to tackle the issues raised, focusing on staffing levels, infrastructure, and operational processes. Plans for workforce assessments, temporary modular expansions, and potential new facility developments were discussed as part of the hospital’s strategy to alleviate overcrowding and enhance patient care.
Collaboration with Welsh Government and local authorities is underway to address short-term and long-term challenges, with a key emphasis on community-based care services to reduce hospital admissions. The health board’s commitment to patient-centric care and continuous improvement was emphasised, highlighting ongoing efforts to address feedback and implement necessary changes.
In conclusion, the inspection findings at Morriston Hospital have underscored the critical need for immediate improvements to address patient safety concerns and enhance overall healthcare delivery. The collaborative efforts between Healthcare Inspectorate Wales and Swansea Bay University Health Board signify a shared commitment to ensuring the highest standards of care for patients in Wales.