A SENIOR doctor at the Aneurin Bevan University Health Board's (ABUHB) flagship hospital has said that current demand on healthcare services is "horrific" - but praised the "amazing" work of staff.

Dr Owain Chandler is the clinical director of the emergency department at the Grange University Hospital.

He has worked at the hospital, near Cwmbran, since it opened two years ago and has worked in the ABUHB since 2012.

A recent inspection of the hospital resulted in Health Inspectorate Wales (HIW) calling for urgent improvements at its accident and emergency (A&E) department.

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, Thursday, 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".

Responding to the report, Dr Chandler said that none of the findings had come as a surprise.

South Wales Argus:

"We’ve got to acknowledge the report and the concerns it’s raised," he said.

"We work in that environment day to day so the concerns about the size of the waiting room or long waits, they’re not a surprise to us or to the staff.

"Working on that environment is challenging for our staff, but I don’t think the release of the report will have too much [negative] impact on them."

Dr Chandler said that the Grange often came in for criticism due to being the region's flagship healthcare centre.

"I think we get a spotlight shone on us because we are a new hospital," he said.

"I get that, it’s easy to criticise, but the design of our model here is trying to keep those minor injury patients away from the Grange."

He explained that the Grange was "built with a plan that patients would flow through it once they’d had their critical care dealt with".

They would then step down to a community hospital or get discharged home.

"The pressures on all our hospitals, and on social care, are the biggest problem," Dr Chandler said.

The issues with what he described as the flow through the hospital, was one of the factors cited as exacerbating the problems at the Grange.

However, Dr Chandler stressed that the pressures on emergency care "are the same up and down Wales and the UK".

"Demand on emergency departments, anywhere you go, is horrific at the moment," he said.

Did the Grange open too soon?

There have been some claims that the hospital opened before it was ready.

However, Dr Chandler said that he believes the decision to open the Grange was the right one.

"It opened earlier than planned, that is a fact, as part of our response to the Covid pandemic which was something not predicted by anyone," he said.

"There were some parts of the processes and flows which we didn’t have the chance to test quite as much as we wanted to.

"However, the decision at the time was right.

"I don’t think we can blame opening early for our problems. If we were working in the [Royal] Gwent and Nevill Hall now we would both be struggling."

Was opening during the Covid pandemic too steep a learning curve?

The sudden influx of high numbers of patients during the coronavirus pandemic would not have given staff at the Grange any time to get to know the subtleties of the hospital system.

However, Dr Chandler said that it wasn’t necessarily the volume of patients at that time, it was the types of patients.

"There were those who had very specific needs, that was the driver of a lot of the reasons hospitals were struggling," he said.

"Closing two emergency departments and opening one was always going to be like going off with a bang.

"We planned for that by visiting other trusts around the UK which had made similar moves."

Staff are doing all they can in a difficult environment

Despite the concerns raised in the HIW report, one thing remains consistent - both in the report and speaking to those on the ground such as Dr Chandler.

The efforts of staff at the Grange has been praised throughout.

"The report is very positive about the staff," Dr Chandler said.

"They are hardworking, compassionate, they’re delivering safe and effective care in what is a very difficult environment.

"The inspectors said that they would be happy for their families to receive the care that we are giving."

He said that the hospital had received lots of positive feedback on the improvements made since the last inspection.

"What has been consistent in the feedback was that the care and the staff was amazing," he said.

"It is difficult working in that environment. I talk to colleagues across Wales and they’re all having the same sort of time.

"It never ceases to amaze me how they [staff] can deliver such good care under such difficult circumstances."

Dr Chandler stressed that the care at the Grange is "safe and effective".

"Yes, you might have a long wait," he said.

"Yes, our waiting room isn’t as nice as we want it to be.

"Ultimately, if you are sick and you need us, we are here."