Health Secretary asked to step in to 'rescue' Arrowe Park Hospital A&E after critical inspection

Birkenhead MP Frank Field has written to the Government's health and social care chief Matt Hancock saying he felt "sheer horror" at the way patients were treated.

You can read the letter at the end of this article

Mr Field told him: "The findings make clear that notwithstanding the valiant efforts of front line staff at the hospital, my constituents are exposed to unacceptably high levels of risk.

"The RSPCA would never allow animals to be put at risk in this way - so why should my constituents be let down so badly?

"I would be grateful if you could please direct additional resources and expertise so that the care and treatment available to my constituents is brought up to the highest possible standard and these shocking flaws are consigned to the history books."

Among issues in A&E discovered by the the watchdog were:

Patients were regularly left for long periods on trolleys in corridors.

There were significant delays in most aspects of the service including triage delays of more than two hours.

Waiting for a specialist to review a case could take more than 14 hours.

Levels of paediatric-trained nurses overnight did not meet minimum standards.

Risk of infection was not well controlled. 

The CQC carried out its inspection in March.

The department was previously inspected in March last year as part of a trust-wide review and rated "Requires Improvement."

The latest inspection report shows the rating of Requires Improvement is unchanged.

Ellen Armistead, deputy chief inspector of hospitals, said: “It is positive to note that staff and leadership were largely working well together to improve the care being delivered and drive the service’s overall performance forward.

“However some patients did wait a long time to be seen and we had some concerns over how patients were being assessed when arriving at the hospital, a view shared by all the staff we spoke to about it.

"We also saw how patients were being treated in the corridors which could affect their dignity and, at the time of our inspection, the flow through the service was poor, creating additional pressures.

“We will continue to monitor the trust closely and return to inspect again soon.”

Janelle Holmes, chief executive of Wirral University Teaching Hospital, said: “We thank the CQC for their recent inspection of our emergency services here in Wirral and welcome the report.

"It is pleasing that inspectors reported notable improvements to our staff and leadership teams, and that this was resulting in a better experience for many of our patients.

“Our Emergency Department is a very busy part of the hospital and we thank our staff who continue to work tirelessly to provide the best possible care for patients.

"Rapid progress is being made in our improvement work and we recognise that we still have work to do.

“We acknowledge the areas of concern and have a number of initiatives in place to address these issues.

"We look forward to the next visit by the CQC so inspectors can see the further improvements we have made.”

The reports says inspectors saw how most staff were working efficiently with each other and other healthcare providers to minimise disruption to patients and were proactive in seeking better ways to improve care to patients with complex needs.

Senior management were present in the service during peak times and staff spoke positively about their leadership, stating they were approachable and ready to actively support staff.

Inspectors found staff were happier and the trust had worked well to improve the working culture and overall engagement in the service, despite months of significant pressure.

However, there were concerns that the trust had little oversight of the training and performance of the streaming service, which initially assesses and directs patients for treatment, staff expressed worry about the safety of the arrangement.

Inspectors reported privacy screens could not be used when treating patients in corridors due to the physical layout of the service, this meant patients’ dignity could be compromised when examined.

There were also significant delays in treating patients and the patient "journey" through the service was not meeting demand placing additional pressure on staff and the operation of the service.

There were further concerns over the paediatric-trained nurse staffing at night time not meeting the minimum standards recommended by the Royal College of Paediatrics and Child Health, and some sharps bins in the service were overfilled.

Among recommendations are:

Improve performance in the national 15-minute triage recommendation, ensure triage processes meet national best practice guidance.

Ensure adequate risk controls are in place for patients who wait extended periods for triage.

Improve the effectiveness of internal professional standards for patients who need a specialist review and reduce delays in decision to admit times.

Improve specialist review times.