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HIW inspection identifies patients are not consistently receiving an acceptable standard of care at the emergency department at The Grange Hospital

Healthcare Inspectorate Wales (HIW) has issued a report (10th November 2022) highlighting the need for urgent improvement in the emergency department at The Grange Hospital in Cwmbran.


A HIW inspection identified that Aneurin Bevan University Health Board did not have adequate arrangements in place within the department to support the delivery of safe healthcare.

HIW completed an unannounced inspection of the emergency department on three consecutive days in August this year. During the onsite inspection, HIW inspectors were not assured that the processes and systems in place were sufficient to ensure that patients consistently received an acceptable standard of care.

A number of issues requiring immediate assurance were identified by the inspection team and are referenced in the report. These include the risk of cross contamination in an area known as the ‘COVID corridor’, resuscitation equipment was not being checked daily, out-of-date medicines were found and there was a lack of security around substances which could be harmful to the patients - these including medication and prescription pads.

Inspectors observed staff striving to deliver good quality, safe and effective care to patients, within a busy challenging unit. Patients told inspectors they were happy with the way that staff interacted with them and were complimentary about the dedication shown by staff and the care provided. Many patients were critical of the departments waiting times.

Comments from staff showed that they could not always deliver care to the standard they wanted due to the increasing pressure and demand on the department. Our findings did highlight management and leadership was good, with staff stating they felt supported. Management was visible within the department, including the nurse in charge who was identifiable and accessible.

There were a number of improvements needed to ensure dignified and timely care could be provided to patients. This includes work required to the physical environment of the waiting room to ensure that it is fit for purpose. The area is very small and cramped and during the inspection, some patients had been waiting on uncomfortable chairs, and in the back of ambulances, for over 15 hours. Until the flow of patients into and through the department can be improved, the health board will find it challenging to address a number of our concerns.

In addition to the areas which required immediate action be taken in order to keep patients safe, HIW has urged the health board to carefully consider all findings from this report and undertake action to reduce the potential for significant harm to patients and to embed all improvements into practice.

Chief Executive of HIW, Alun Jones said:

Our inspection findings are extremely concerning and we have urged the health board to take action to improve the processes and systems in place within the emergency department so that patients receive safe, timely and effective care. I hope this report will accelerate the measures taken to drive forward timely improvements. We will be working closely with the health board to ensure robust improvements are made and evidenced.

Full Hospital Inspection Report

Inspection Summary Report