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Medway Maritime Hospital emergency department unable to cope with number of patients, following CQC inspection

By Clare Freeman

The emergency department at Medway Maritime Hospital is unable to cope with the number of patients, the health watchdog has found.

During an inspection of the hospital, the Care Quality Commission (CQC) found that during the busiest times patients were waiting too long to see a doctor or being left unattended while they waited.

Professor Sir Mike Richards, Chief Inspector of Hospitals, said: "In the latest inspection, we were concerned by the lack of active clinical leadership in the accident and emergency department and the subsequent risk to patient safety.

Medway Maritime Hospital. Library image
Medway Maritime Hospital. Library image

"In the busiest times, the Emergency Department was not able to cope with the numbers of patients attending: patients in need of treatment were waiting too long to see a doctor, or were being left unattended while they waited."

The emergency department is designed for around 45,000 visitors but sees more than 100,000 people per year, roughly 275 patients each day.

A spokeswoman for Medway NHS Foundation trust said: "We are aware of the CQC's interim findings and are working with our healthcare partners in NHS England and within Kent to address the issues that they have raised. We share the CQC's commitment to the delivery of excellent patient care and are doing our utmost to deliver this."

The inspection, which took place in the last week of August, was part of a comprehensive inspection schedule and to follow up concerns identified in the previous inspection in July 2014.

"We were concerned by the lack of active clinical leadership in the accident and emergency department and the subsequent risk to patient safety" - Prof Sir Mike Richards

The trust has been in special measures since July 2013 following the Keogh review into death rates.

Subsequent inspections from the CQC in April and May 2014 found urgent improvements were needed to the maternity and the A&E departments.

A further inspection in December 2014 found the hospital was still not making enough progress.

Since then, Lesley Dwyer has been appointed as the new chief executive and A&E has been undergoing a series of restructuring work funded by £13.4m from the Department of Health.

In the last quarter, April to June, more than 25,000 people visited the department with 1,827 people waiting more than four hours to be seen.

Each week, an average of 92.9% of patients were seen within the government’s four-hour target time. But it is still behind the government’s national target of 95% of patients.

In some weeks at Medway as many as 96.9% of people were seen within the four hours, in other weeks that dropped to 90.1%.

In July, there were 9,040 admissions to A&E with just 86.7% seen within the target time. The figures for August have not been released yet.

At the end of 2014 just 79% were being treated within the target, the worst the hospital has seen.

Professor Richards said their concerns had been raised with the trust and local commissioners.

He said: "We have been kept fully aware of all action taken by local clinical commissioning groups, local authorities and NHS England to ensure that the trust’s urgent and emergency services can cope with the demand to deliver safe, effective, compassionate and high quality care, and we are continuing to work closely with all agencies.

"In the meantime, we will continue to monitor the trust closely. If we had any further concerns about the safety of the service, we would consider using our urgent powers to protect the continued safety and wellbeing of people who rely on this service."

The full findings of the inspection will be published later this year.

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