An over-stretched hospital grappling with bed shortages, mould and a diarrhoea outbreak has outlined plans to improve after it was savaged by watchdogs.

Arrowe Park Hospital’s emergency department has responded to the findings of a critical Care Quality Commission (CQC) report which identified a catalogue of failings at the Wirral facility.

Paul Moore, Director of Governance and Quality Assurance at the trust that manages the hospital said staff faced ‘unrelenting pressure’, to the extent where ‘corridor care’ had become the safest way of dealing with patient flow.

Speaking at an Adult Social Services Scrutiny Committee in Wallasey Town Hall on Wednesday he said: “[Corridor care] is a difficult one, it presents an operational dilemma. When you haven’t got any beds for people to go to and people are coming through the door, where do you place people?

“Often the safest option is for people to be in and around the proximity of the emergency department within access to resuscitation facilities and staff should they need it, rather than being squeezed into a space somewhere else in the hospital which may not be appropriate.

“I’ll be the first to acknowledge that this is less than satisfactory but it sometimes represents the least risky alternative for the patient when you are in that situation.”

The hospital boss said many problems identified by the CQC inspectors were symptoms of a much bigger issue of people spending too much time in hospitals – leading to congestion in emergency departments.

The CQC critcised the Arrowe Park for leaving vulnerable patients in hospital corridors for hours following a surprise inspection in March.

Two hour delays for triage treatment, delays assessing patients who were deteriorating and not enough pediatric nurses working overnight were also identified in the report.

Mr Moore said: ” The key thing that will be a concern to members is the issue around the responsiveness to patients waiting for initial assessments in triage.

“This was a combination of very high levels of bed occupancy and high demand, and insufficient patient flow.

“When those factors combine, your pressure point is inside the emergency department because people continue to come in and there’s nowhere for them to go.”

Mr Moore said corridor care had been in practice for some time at Arrowe Park’s emergency department, and was commonly used in under-pressure hospitals.

However he said the trust had accepted the CQC findings and had drawn up an action plan to improve.

He told Wirral Councillors that hospital bosses had taken “immediate and decisive action” to cease the routine use of corridor care, by expanding the front door of the emergency department to open a ‘reverse cohort area’ where up to 12 people can wait on trolleys for assessments.

He said this would provide a better standard of care, but was only a temporary solution while bosses address the wider issue of patient flow.

He said: “It’s a better standard of care, but that can quickly be exhausted when you are under enormous pressure.

“If we were to experience a mass casualty, or a surge in patients coming with pandemic disease, I cannot give an undertaking that we will not in those circumstances be using corridors, but if we were it would be on an exception basis.

“This [reverse cohort area] is a temporary solution to a problem that’s much bigger than the emergency department. it’s about the flow of patients in and out of the hospital and in and out of the hospital system that is the underlying problem where we should be applying our focus.

“I know my colleagues are working extremely hard to find a way forward on that in anticipation of what could be a difficult winter.”

The CQC report applied only to Arrowe Park’s emergency department, which is managed by the Wirral University Teaching Hospital Trust.

Mr Moore said that while the trust accepted the CQC findings, one recommendation to have two registered overnight sick nurses on duty at all times would pose a challenge, because there were ‘not enough in the country’ to fulfill such an objective.

Another key issue he vowed to tackle was infection prevention following an outbreak of clostridium difficile – a bacteria that can infect the bowel and cause diarrhoea.

Mr Moore said the strain of this infection in the community and the hospital was a “difficult one to eradicate” and said environmental cleaning was one way they were addressing this.

However it will be an uphill struggle for the hospital, because of the condition of the run down building, many parts of which have mould and old flooring that is difficult to clean.

Mr Moore promised an “all out war on bacteria”, with action being taken including an ‘all out campaign on infection prevention’, a review of defects to the building and the redevelopment of two wards as exemplar sites to improve hygiene.

While the hospital face a number of uphill challenges, staff were praised by the CQC.

Inspectors hailed staff for their “resilience and compassion” as they struggled to help patients frustrated by significant delays, including when they faced aggression and verbal abuse.