Grange Hospital in Cwmbran needs urgent improvements in A&E

A team from the Health Inspectorate Wales (HIW) turned up unannounced at the hospital on three consecutive days in August.

In their report, published today, the inspectors said they "were not assured that the processes and systems in place were sufficient to ensure that patients consistently received an acceptable standard of care".

HIW chief executive Alun Jones has called the findings "extremely concerning".

A spokesman for Aneurin Bevan University Health Board said it "recognised" issues raised with the A&E waiting area and patient flow, and work was under way to address these.

Inspectors flagged a series of issues which need "immediate assurance", including:

• A risk of cross contamination in an area known as the "Covid corridor";
• Resuscitation equipment not being checked daily;
• Out-of-date medicines;
• A lack of security around substances which could be harmful to the patients, such as medication and prescription pads.

Inspectors said staff were "striving" to give "good quality, safe and effective care" and many patients were full of praise for the people looking after them.

But "increasing pressure and demand on the department" meant A&E staff "could not always deliver care to the standard they wanted", the health inspectors noted.

There are also ongoing problems with patient flow - a problem not specific to the Grange, but which is an obstacle to "dignified and timely care" at Gwent's flagship hospital.

Inspectors have recommended the "very small and cramped" waiting room in the A&E department be improved "to ensure that it is fit for purpose".

Some patients had been sitting in ambulances or on "uncomfortable" chairs for more than 15 hours, the inspection team found.

Ambulances outside the Grange University Hospital. Picture: Huw Evans Picture Agency

"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," they added.

The health board has now been urged by HIW boss Mr Davies to "take action... so that patients receive safe, timely and effective care".

He added: "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."

In response to the report, a spokesman for Aneurin Bevan University Health Board said: “We welcome the findings of the report and whilst we acknowledge and have responded to the concerns raised, we are encouraged that the report and the feedback received from HIW recognised the improvements made at the emergency department at The Grange University Hospital since the last report six months ago."

The spokesman added the health board was "pleased" by positive feedback regarding the work of staff.

“Like all hospitals across Wales and the UK, the Grange University Hospital continues to face extraordinary challenges due to staff shortages, increased demand and the after effects of the Covid-19 pandemic on people’s health," he said.

"We are working hard to improve the experience of patients who visit the hospital.

"We recognise there are issues around the emergency department’s waiting area, but we would like to reassure people that work is already under way to increase capacity in this area.

“HIW have also indicated that improvements to patient flow and waiting times are required, which we fully accept.

"Whilst this is a nationally recognised problem, caused by system-wide pressures across health and social care, we are working hard to improve patient flow and reduce waiting times.

"We have already introduced a closer partnership working initiative between emergency Department staff and the Welsh Ambulance Service to improve ambulance handover times, as well as introduced a Same-Day Emergency Care Unit (SDEC) to offer eligible patients more timely care and to free up space in the emergency department.

Peter Fox, the Conservative member of the Senedd for Monmouth.

Peter Fox, the Conservative MS for Monmouth, said the report was "damning" and renewed calls for improvements at the Grange.

"Patients and families expect nothing less than basic principles of care and safety when in hospital – which sadly appear to be lacking," he said.

The report "paints a disturbing picture of a struggling hospital", according to Peredur Owen Griffiths, Plaid Cymru MS for the South Wales East region.

"Despite the best efforts of the dedicated staff at the Grange, patients are waiting for far too long in a hospital waiting room that is too small and too uncomfortable.

"This flagship hospital was only officially opened last year and it beggars belief that such fundamental flaws have become apparent so soon."

He added: "There is also an urgency to get this sorted before the inevitable added pressure that comes every winter. There is no time for the health minister to lose."