The national health watchdog has finally released its long-awaited findings following an inspection at one of Kent’s busiest hospitals.

And more than a year after the emergency department at Medway Maritime Hospital came under scrutiny, its rating has dropped from “good” to “requires improvement”.

The Care Quality Commission, which looked at the A&E service at the Gillingham hospital in February last year, has apologised for the publication delay, blaming an IT glitch.

But it has issued a warning notice to the trust saying it must focus on making specific improvements including tackling the problem of overcrowding and treating patients in undesignated areas.

Jayne Black, chief executive of Medway NHS Foundation Trust, said that while they acknowledged shortfalls needed to be addressed, “significant improvements” had been made in the last 12 months.

The 31-page CQC report highlights overcrowding and long waits in corridors, which impact patients’ privacy and dignity, leading to “degrading” situations.

It followed numerous reports of people being cared for in “undesignated areas”, namely corridors, for more than two days because beds on the wards were occupied.

Inspectors found frail patients were told to soil themselves as there was nobody to take them to the toilet and one complained of “sitting in faeces all day”.

An elderly woman had to use a bedpan with no screening in an area accessed by the public.

Staff shortages led to patients going up to seven hours without pain relief, and there was a lack of bedding and washing facilities.

Housekeepers complained that cramped conditions impacted their cleaning operation.

An employee told the regulator that they were “overwhelmed by overcrowding and, as a result, patient safety was compromised”.

A member of the medical team was seen “crying on the phone for help”.

Responding to the report, Ms Black highlighted areas where changes have been made, including a new multi-million-pound ward with more than 30 beds for patients with serious breathing or heart conditions, which opened last April.

Improvements had also been made in waiting times, with the Trust exceeding the national target to see, treat, discharge or admit patients within four hours. This rate amounted to 78% throughout most of last year - up from 66% in December 2023.

Ambulance handover times were, on average, 14 minutes in January this year which is below the national average.

Public feedback showed that 75% of those who responded had a “positive experience of care”, which was up from 65% in January 2024.

Also, “improvement huddles” had been introduced where teams gather to raise and address concerns and come up with solutions.

Ms Black said: “While the report details examples where we let patients down, it also recognises that many patients ‘had a good experience of the department with staff being compassionate and receiving care and treatment in a timely manner’.”

Inspectors also praised a “supportive culture at local level” and recognised that “staff were committed to providing care in challenging circumstances. Staff and leaders were proud that partnership working had reduced ambulance off-load times.”

Ms Black added: “We are very sorry that despite the best efforts of our hard-working staff, at the time of last February’s inspection, the inspection team found that our care fell below the standard that everyone should expect in their time of need.

“Over the last year, we have made significant improvements so that patients attending our Emergency Department are treated sooner, are cared for in areas more suitable for their needs, and receive appropriate and compassionate care.

“We recognise there is much more for us to do, particularly to reduce delays for patients waiting to be admitted to a ward, so that every patient receives the high standard of care that we aspire to provide.

“Staff throughout the hospital continue to work tirelessly, together with our ambulance, community and social care partners, to reduce delays and improve care for all our patients attending our Emergency Department.”

After releasing its outcome, the CQC said: “Due to a large-scale transformation programme at [the] CQC, this report has not published as soon after the inspection as it should have done.

“The programme involved change to the technology CQC uses but resulted in problems with the systems and processes rather than the intended benefits.

“The amount of time taken to publish this report falls short of what people using services and the trust should be able to expect, and CQC apologises for this.

“While publication of some reports has been delayed, any immediate action that CQC needed to take to protect people using services will not have been affected and acted upon appropriately.

“CQC is taking urgent steps to ensure that inspection reports are published in a much timelier manner.”

The full report will be published on the CQC website shortly.

Inspectors look at five categories when compiling their report. They found safety at Medway A&E was “inadequate”, effectiveness “requires improvement” as did caring and responsiveness. However, when considering whether it was well-led, they felt it was “good”.

In its statement, the CQC added: “The trust has engaged well with CQC and taken steps to start addressing the issues highlighted in this report.

“CQC has continued to monitor the trust during this time, to ensure people are safe whilst these improvements are being made and will return to check on their progress.”

Sittingbourne and Sheppey MP Kevin McKenna (Lab) said: “I know that like me, many other people living in Sittingbourne and Sheppey will be very concerned on hearing the findings in the CQC (Care Quality Commission) report on Medway Maritime Hospital, run by Medway NHS Foundation Trust.

“The report is based on an inspection from early last year and is very difficult reading - I'm appalled by the conditions that patients and staff have been faced with.

“Nobody should have to wait for 50+ hours without access to wash facilities, and staff must be able to speak out without fear of reprisals.

“I'm glad to hear that since the inspection, through the hard work and incredible dedication of Medway’s NHS staff, there have been improvements made to many of the problems identified by the CQC. It is clear though that more must be done.

“The Labour government was right to call in Lord Darzi to review the state of the NHS and diagnose its problems. I fully support his recommendation to shift more care from hospitals into the community, as for people here in Sittingbourne and Sheppey, this is the biggest single thing that would improve their care.

“This approach is already taking shape, with the Community Diagnostic Centre and new beds on Sheppey helping to ease pressure on Medway Maritime Hospital.

“However, we must go further. I urge the Kent and Medway Integrated Care Board to collaborate with Kent County Council and other organisations and care providers locally, to bring Integrated Neighbourhood Teams to Sittingbourne and Sheppey — a model that has shown successes in East Kent and other areas of the UK.

“These teams will strengthen support for both our GPs and hospital services, ensuring patients, especially those with the most complex needs, get the care they need closer to home.”

Naushabah Khan, MP for Gillingham and Rainham, said: “The report specifically identifies that the quality of care has been impacted by overcrowding, understaffing, mismanagement of medicine and clinical incidents going unreported,

“Instances of patients waiting up to 50 hours to be seen or expected to soil themselves as staff were unable to take them to the bathroom is frankly unacceptable.

“The lack of privacy, dignity and poor experience highlighted in the report is unfortunately consistent with the testimonies I have received from residents across Gillingham and Rainham.”

Miss Khan recognised that improvements had been made since the CQC visit last February and that staff were committed to providing care in “challenging circumstances”.

She added that she was launching a health partnership programme bringing together health stakeholders to address local challenges.

She said this tied in with the government’s NHS 10-year plan due to be published this spring, aimed to “get our NHS back on its feet”.

Rochester and Strood MP Lauren Edwards said: "I welcome the publication of the Care Quality Commission (CQC) report on Medway Maritime Hospital, which highlights serious concerns about patient safety and the quality of care.

“While urgent improvements are needed, I want to recognise the dedicated clinicians and staff who work under immense pressure, serving one of the largest catchment areas in the south east. High demand has put significant strain on services, and these challenges must be properly addressed.

“The CQC has issued a warning notice requiring urgent and emergency care services to improve after finding multiple regulatory breaches. I welcome assurances from Medway NHS Foundation Trust that action is being taken, but these changes must happen swiftly.

“I have also spoken with Paul Bentley, chief executive of the Kent and Medway Integrated Care Board (ICB), about wider pressures on local NHS services, and I will continue working with healthcare leaders and ministers to drive improvements. I also welcome the Labour government’s additional £20bn NHS investment, which will support much-needed improvements.

“Alongside this, I will keep pushing for investment in a new Elective Care Centre in Chatham to ease pressure on Medway Maritime, improve patient care, and support town centre regeneration.

“Residents rightly expect safe, high-quality healthcare within Rochester and Strood and across Medway.”