Weston General improving after warning from inspectors

WESTON General Hospital has started to make improvements to its A&E after it was handed a warning notice – but it is still suffering from a shortfall in permanent nurses.

The Care Quality Commission rated the emergency department ‘inadequate’ in February last year and it was told to improve.

In December the department, which is closed overnight, was issued with a warning notice after inspectors found that the supervision of junior doctors was variable, governance was still not operating effectively, and they had limited assurance the nurses had the skills and experience to provide safe care and treatment.

It managed to make improvements despite the challenges of the Covid-19 and an outbreak that claimed the lives of 18 patients who contracted coronavirus in the hospital.

A report from a CQC inspection in July, published yesterday, said the service had enough medical staff to keep patients safe but not enough were permanent. Inspectors were concerned about the trust’s reliance on the emergency department’s clinical lead, which created a “huge vulnerability”.

There was also a shortage of permanent nurses, with one in five roles vacant, and a heavy reliance on bank and agency staff, although there was a pool of temporary workers to prevent short staffing. The shortage of nurses meant junior doctors sometimes picked up tasks like taking blood samples.

There was not an effective process to tell staff what they needed to do in response to national alerts, and managers did not always share lessons from incidents and near misses.

The CQC also said the trust found it difficult to show that nursing and medical staff were compliant with mandatory training.

However, the inspectors found that there was good oversight, a backlog of incidents had been significantly reduced, and staff felt respected and able to focus on patients’ needs.

The CQC said the trust must ensure that staff learn from incidents and are supported to complete mandatory training.

It must ensure that staff are aware of national safety alerts so patients receive the recommended care.

It should take further steps to improve the training of junior doctors, and consider a system to alert staff if there is an infectious patient in the department.

Amanda Williams, the CQC’s head of hospital inspection for the South West, said: “Weston General Hospital is now part of University Hospitals Bristol and Weston NHS Foundation Trust and at this inspection we found that the new leadership team had started to implement the improvements the department needed.

“The team know what further improvements are needed. We will return to check that those improvements have been made at a later date.”

Carolyn Mills, the trust’s chief nurse, said: “We are pleased the CQC has recognised the ongoing improvements within the department, especially as the inspection was undertaken during what has been a challenging time, not only within the hospital itself but across the wider NHS, as we have responded to the global Covid-19 pandemic.

“We recognise there is still more to do to build on the improvements noted by the CQC and would like to thank staff for their ongoing dedication and professionalism.”

The A&E is currently open from 8am to 10pm. It has been shut overnight since July 2017 because it could not guarantee safe staffing levels. The hospital closed to new patients for three weeks in May after an outbreak of Covid-19.

The trust said it was “deeply sorry” after an investigation found that 18 people may have died as a direct result of contracting coronavirus in the hospital.