Second inspection finds improvements in A&E at Queen Alexandra Hospital – but more work needs to be done

Ambulances outside QA Hospital
Ambulances outside QA Hospital

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  • July was the busiest month of the year with an average of 403 attendances a day
  • Trust still missing 95 per cent target with an average of 82 per cent last month
  • Care Quality Commission said although changes have been made, more needs to be done
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A SECOND inspection of Queen Alexandra Hospital’s A&E department has found that while urgent improvements have been made, more needs to be done.

After an inspection in February, the emergency department was deemed inadequate for providing a safe service – an overall rating of requires improvement was given.

We have made significant improvements within A&E, despite continuing to see exceptionally high rates of attendances

Ursula Ward, chief executive of Portsmouth Hospitals NHS Trust, which runs QA

The Care Quality Commission, which carried out the inspection, issued two warning notices to Portsmouth Hospitals NHS Trust, which runs QA.

Changes made were improvements to the initial assessment of A&E patients, safe delivery of care and treatment, and management of emergency care.

England’s chief inspector of hospitals Professor Sir Mike Richards said: ‘At our last inspection our most urgent concern was the risk to patients arriving by ambulance.

‘We took proportionate action to protect patients and, subsequently, PHT has worked to address our most serious concerns.

‘While I note there have been some significant improvements, some patients are still having to wait too long to be admitted and I expect the trust to address this as a priority.

‘Our inspectors will return in due course to check progress in this area.’

Results published today of the latest inspection, which took place in April, found:

* Patients arriving by ambulance were being assessed within 15 minutes by a nurse.

* Staffing levels had improved.

* Nurses were now allocated to the corridor areas, organising activity.

* But there were still delays for patients waiting to see specialist doctors and be admitted even at times when beds were available in the hospital.

* Patients brought in by ambulance continued to wait in a corridor, some for over an hour.

* Patients waiting in corridors were not always 
being observed and monitored when staff were on breaks.

* Nurse staffing levels had not been assessed for the ambulance area.

Trust chief executive Ursula Ward said: ‘We have made significant improvements within A&E, despite continuing to see exceptionally high rates of attendances.

‘We know there is still work to do, we are progressing with a programme of improvements, alongside our colleagues in the local healthcare system.’

‘Better flow in system will help A&E waiting times’

THE head of the trust that runs Queen Alexandra Hospital said patient flow through the site is key to bringing down A&E waiting times.

Speaking at a Portsmouth City Council’s health, overview and scrutiny panel meeting, Ursula Ward said Portsmouth Hospitals NHS Trust is committed to improving things.

She said: ‘There can be about 120 people in hospital beds that don’t need to be there.

‘Some of that is absolutely the hospital and we have to be ruthlessly consistent in making sure we adhere to national standards that will get the flow going out of the hospital – we have a lot of work to do on that.

‘We know the pharmacy in QA needs to work better, so that is something we will look at.’

She also said more work needs to be done by community providers and council authorities to make sure care packages and help at home is available when a patient is ready to leave.

Ms Ward added: ‘We also need our community provider and local authority partners to deal with patients quicker too.

‘Portsmouth is able to respond quicker and part of that is because it has got better integrated teams.

‘About 80 per cent of our patients who are waiting to be discharged are Hampshire based rather than Portsmouth.’

A&E waiting times are getting better – between April and June, the Portsmouth Clinical Commissioning Group, set QA a target of seeing, treating or discharging 81 per cent of people within four hours.

PHT achieved 82.2 per cent. The national target is 95 per cent.

July was the busiest for QA with 12,489 A&E attendances, an average of 403 a day, with performance at 82 per cent.