Staff and patients at risk of catching Covid at South London hospital, inspection finds

By Tara O’Connor, Local Democracy Reporter

Staff and other patients were at risk of catching Covid in waiting rooms and on their way to the toilet at a South London hospital, inspectors have found.

The Care Quality Commission (CQC) carried out an unannounced inspection of Croydon University Hospital’s emergency department in September.

Inspectors told the hospital to improve.

Croydon Health Services Trust has now pledged to make “positive changes”.

The CQC found a waiting area for adults with suspected coronavirus was near a corridor people used to access the toilets, putting staff and other patients at risk.

It also found that the waiting area for children was overcrowded and kids were not being assessed and prioritised in the recommended 15 minutes.

Inspectors also spoke to workers who said their jobs were becoming unmanageable due to staff shortages and more admissions.

Shortages in nursing staff was particularly prevalent in the children’s department.

But in the adult emergency department, inspectors found that there were enough nurses and support staff to keep patients safe and provide the right care and treatment.

The trust says that since the inspection it has started a recruitment drive for paediatric nurses to reduce pressure on the department.

It is also set to launch a dedicated children’s unit next spring.

The inspection was carried out as a follow up after a 2020 inspection found that mental health patients in the emergency department could be at risk of harm.

But Nicola Wise, CQC’s head of hospital inspection, said that the trust had now responded to these concerns.

Ms Wise said: “When we inspected the emergency department at Croydon University Hospital, we were pleased to see the trust had responded to our concerns about the care and treatment of patients with mental health conditions which we raised in previous inspections.

“The emergency department had a new leadership team in place who understood the challenges the service faced, and they were developing strategies to address these.”

Other issues discovered by her team included safety checks not being completed on some resuscitation trolleys in the children’s department, meaning they may not be ready for emergency use.

Ms Wise added: “Whilst it was reassuring that all serious incidents and near misses were reported immediately and reviewed, it was concerning that, at the time of the inspection, there were still over 1,500 incidents awaiting a full review and investigation, so lessons could be learned and shared with the wider team.

“Risks to the department, such as staff shortages and overcrowding in the waiting area, were also not being recorded, along with actions needed to address them. This meant that the service was missing vital opportunities to protect patients from harm. However, the leadership team assured us that they had plans to manage the backlog of incidents.”

“However, we found further concerns on this inspection. The waiting area for children was overcrowded, and the waiting area for adult patients with suspected COVID-19 infections was near a corridor which people used to access the toilets. This meant that staff and patients were not being properly protected from the risk of spread of COVID-19 and other infections.”

The trust will continue to be monitored by the CQC.

A spokesperson for Croydon Health Services Trust said: “Despite these positive changes, we recognise that there is still much more to do to ensure we can deliver on our ambitions to consistently deliver excellent care for every patient.

“This includes the continued promotion of social distancing in waiting areas, despite increasing demand for our services, increasing the number of staff in our Children’s Emergency Department and continuing to embed our safety and governance policies within teams.”

The spokesperson added that it is working with health partners in Croydon to ensure patients are seen at the right place and those who are ready to leave can do so quickly to reduce bed blocking.

They added: “We are committed to working with our staff and our local communities to ensure we make even more progress, while delivering the highest standards of care.”

They added: “Every patient is screened on arrival to keep our patients and staff safe from COVID-19. To protect people in our care, patients that are suspected or confirmed as having the virus are treated in separate clinical areas. The CQC also found that all areas of the Emergency Department were visibly and routinely cleaned, and that all staff consistently used personal protective equipment (PPE).

“We are seeing unprecedented numbers of people requiring emergency care, and it can be challenging at times too physically distance all patients within the Department. We continue to monitor this through regular safety checks and we have clear guidance in place for patients to stay socially distanced and use of face coverings, with hand washing stations throughout the department to help prevent the spread of COVID-19.”