Staffing crisis saw dead patients left on wards for hours
Hospital inspectors reveal shortage amid pandemic
ADEAD patient was left on a ward for nearly five hours and another died after a fall at a Birmingham hospital as staff failed to cope amid the Covid crisis, it has been revealed.
Both incidents happened in December as Good Hope Hospital in Sutton Coldfield was suffering severe staffing issues.
The incidents were revealed in a Care Quality Commission (CQC) report into the way the trust running four Birmingham and Solihull hospitals handled the outbreak.
The University Hospitals Birmingham NHS Foundation Trust runs the Queen Elizabeth, Good Hope, Heartlands and Solihull hospitals and is one of the largest in England.
Surprise inspections were carried out at the QE, Good Hope and Heartlands in December as the third wave of infections started to soar.
Inspectors found that at Good Hope, dead patients were “not always transported from the wards in a timely manner”.
One example saw a patient on Ward 8 who had died at 6.45am, but by 11.35am had still not been removed due to low staffing levels.
The report stated: “This was reported by several staff members and it caused them distress.”
The inspection also highlighted how another patient died and others suffered harm after potentially avoidable falls.
“We were provided with examples of potentially avoidable falls due to low staffing numbers. On Ward 11, a patient fell and passed away after sustaining an injury,” the report states.
“At the time of the fall, the ward was short-staffed, and all staff were busy with other patients. An investigation report was produced as a result which highlighted staffing as a concern.”
Inspectors also raised concerns about nurse staffing at Heartlands and the Queen Elizabeth hospitals.
Other findings by CQC inspectors at the three hospitals included:
There weren’t enough nursing staff to keep patients safe, with one nurse having to care for as many as 17 patients.
Patients who had been Covid negative on admission were put on Covid positive wards.
Staff frequently worked “long” hours beyond their 12-hour shifts to ensure patients were safe.
Some relatives had complained that patients were discharged “in a worse condition than when they were admitted”.
The CQC has made recommendations for the trust, including ensuring that nurse staffing is adequate to keep patients safe.
A spokesperson for University Hospitals Birmingham NHS Foundation Trust said: “There are some issues raised in the reports, all of which we were aware of prior to the inspection, which we recognise as requiring further work and this is ongoing.
“At the time of the inspections, which took place on December 2 and 9, 2020, the trust and our amazing staff were 10 months into a pandemic response with over 450 Covid inpatients on the days the inspections took place, rising to 1,054 Covid inpatients during January.
“The effort of our staff to provide care to what is now well over 11,000 Covid in-patients, during the most difficult period in the history of the NHS, has been and remains quite extraordinary. It continues to be our focus.”
In one ward at Good Hope a single registered nurse was responsible for 17 patients.
And at the QE, inspectors found that healthcare assistants were regularly brought in to boost numbers because of too few nurses. But the watchdog inspectors identified no serious harm to individual patients as a result.
At the time of the visit the hospitals were battling to deal with the rising tide of new admissions with coronavirus, with over 450 people with Covid among its 2,300 patients. The number of Covid inpatients has since more than doubled.
The findings echo serious concerns raised by medics, nursing unions and patient groups about the risks involved in diluting nurse to patient ratios amid unprecedented demand.
Sickness rates among UHB’s registered nurses and support staff at the time of the visits was around eight per cent – double the trust’s target.
At the Queen Elizabeth Hospital, the inspectors reported: “On every ward we visited during our inspection, staff consistently told us that they were short staffed.
“Registered nurse to patient ratios were often one to nine during the day and one to 12 during the night shift.”
To try to ensure patient safety, the hospital was routinely increasing the number of healthcare assistants on duty to balance out absences among registered nurses.
It was a similar picture at Heartlands and Good Hope hospitals, with significant pressure on staffing featuring in each of the three individual hospital reports.
At Heartlands inspectors additionally found examples of infection control measures not being strictly used, including four staff members not wearing face masks properly, and staff members leaving staff rooms unmasked and not putting them back on ‘‘in a timely manner’’.