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Staff praised despite pressures at the Princess of Wales Hospital’s Emergency Department

Healthcare Inspectorate Wales (HIW) has issued a report (25 January 2023) highlighting the impact of patient flow on the care being delivered within the emergency department at the Princess of Wales Hospital in Bridgend. We found that patients generally received a safe level of care. However, despite efforts by the health board, patient flow challenges meant that some patients did not receive timely care and treatment and remained in the emergency department for longer than expected.

Princess of Wales Hospital - Emergency Department

HIW completed an unannounced inspection of the emergency department on three consecutive days in October last year. During the onsite inspection it was clear that staff were working hard to provide patients with a positive experience, despite the pressures on the department. Staff were observed providing respectful care, and patients were generally positive about the service they received.

HIW is aware of the intense pressure being experienced across Wales within primary care, ambulance services and emergency departments. However, the quality of patient care was impacted upon by poor patient flow within the department and wider hospital. At the time of our inspection there were 87 medically fit patients awaiting to be discharged from the hospital with an appropriate care package, impairing the ability of the health board to transfer patients from the emergency department to wards within the hospital in a timely manner.

Our findings highlighted good levels of clinical oversight of patient waiting areas and clinical pathways were regularly being reviewed. HIW identified areas for improvement, including patient privacy and dignity, where corridors and lounge areas were overcrowded. Inspectors found evidence that medicines were managed appropriately, but there needed to be better processes in place to deal with sharps waste, medicine storage and the disposal of PPE.

When consulted, staff described a cohesive and supportive team, providing positive comments relating to local management and leadership support. However, the inspection did identify that the service could improve on how effectively it acted on staff feedback and wellbeing.

The health board has produced a comprehensive plan with detailed 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, the Princess of Wales Hospital continues to face extraordinary challenges due to increased demand. Patient flow is a nationally recognised problem, caused by system-wide pressures and HIW acknowledges the health board is working hard to manage these challenges. In this instance, the evidence from our inspection means we have been able to highlight good systems in place to ensure effective clinical oversight of patients in waiting areas, which supports the reduction in risk for those awaiting treatment.  Our report sets out some specific recommendations which the health board needs to address to further improve. We will continue to engage with Cwm Taf Morgannwg University Health Board to ensure progress against our findings.

October 2022 – Inspection Summary Report – Princess of Wales Hospital, Bridgend

October 2022 – Hospital Inspection, Emergency Department – Princess of Wales Hospital, Bridgend