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Staff praised despite extreme pressures at Morriston Hospital’s Emergency Department in Swansea

Healthcare Inspectorate Wales (HIW) has issued a report (8th December 2022) highlighting the need for improvements within the emergency department at Morriston Hospital. The inspection concluded that despite staff efforts, patients were not consistently receiving quality care.

Emergency Department - Morriston Hospital

HIW completed an unannounced inspection of the emergency department on three consecutive days in September this year. During this period a number of assessment areas were also inspected, including the Children’s Emergency Unit, Rapid Assessment Unit and the Surgical Decision Making Unit.

During the onsite inspection, HIW identified a total of 25 general areas for improvement, including patient privacy and dignity, nutrition and hydration, infection prevention and control, and staffing levels. HIW inspectors observed delays beyond national guidelines, in both triage and the medical review of patients presenting with chest pains including heart attack symptoms. The inspection also identified some patients had been left lying on unsuitable surfaces for extensive periods of time.

HIW is aware of the intense pressure being experienced across Wales within primary care, ambulance services and emergency departments.  However, maintaining patient safety remains paramount. Inspectors reported a lack of timely care and treatment, despite ongoing efforts by Swansea Bay University Health Board to improve patient flow. Patients were generally receiving a safe service, but this was impacted upon by poor patient flow within the department and wider hospital. The report highlights patients were not always triaged, reviewed, or treated in a timely manner. The hospital will be opening a new Acute Medical Unit, incorporating same day emergency care, this month, which aims to reduce pressure on the emergency department.

The onsite inspection highlighted the emergency department was experiencing a period of unrelenting demand on its services. Our findings did highlight good management and leadership, with staff stating they felt supported. When asked, patients stated they were happy with the care provided by staff, however, the environment was not conducive to maintaining patient privacy and dignity due to the high number of patients accessing the service. We saw staff making efforts to maintain patient privacy and dignity, despite limited space available. It was noted that staff were working hard to provide patients with a positive experience and good levels of care despite extreme pressures.

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 including inadequate staff levels and skill mix.

The health board has produced a comprehensive plan with detail actions on how improvements will made at the emergency department.

Chief Executive of HIW, Alun Jones said:

There are mounting pressures on NHS services, and like all hospitals across Wales, Morriston Hospital continues to face extraordinary challenges due to increased demand and staff shortages. Patient flow is a nationally recognised problem, caused by system-wide pressures and HIW acknowledges the health board is working hard to make improvements and reduce waiting times. Our report sets out specific recommendations which the health board needs to address in order to improve.

We will continue to engage with Swansea Bay University Health Board to ensure progress against our findings. Key staff at the health board have been positive in their response to our feedback and in our subsequent communication, with a clear commitment to addressing the issues highlighted.


Hospital Inspection Report

Inspection Summary Report