Mentally ill patients left in A&E for weeks

Hospital staff unable to protect privacy and dignity of people in crisis kept waiting for inpatient beds

PATIENTS have been kept in Accident and Emergency departments for up to three weeks, watchdogs have found.

People undergoing mental health crises were left waiting in an area with no natural light as services struggled to cope with demand.

The Care Quality Commission (CQC) said staff at the Royal Sussex County Hospital (RSCH) admitted the longest time spent on the “short-stay” area of the A&E unit was three weeks. NHS targets say all A&E patients should be admitted, treated or discharged within four hours. The target has not been hit since 2015.

Statistics from the trust show that, on average, such patients stayed more than two days on the A&E unit.

It said the urgent and emergency services at the hospital – part of University Hospitals Sussex Foundation Trust, which is rated “outstanding” overall by the regulator – “did not fully meet the needs of the local population”.

Urgent and emergency services – which were inspected after concerns were raised with the CQC – were subsequently downgraded to “requires improvement” from “good”.

Inspectors found that staff were unable to protect the privacy and dignity of patients spending weeks on the unit. “Due to the national shortage of mental health inpatient beds, patients presenting to the emergency department with a mental health crisis frequently were accommodated in the short-stay area of the department for several days and in some cases for up to two or three weeks,” the report found.

“Although some action had been taken to meet the needs of these patients, such as the provision of a mental health liaison service and employment of agency-registered mental health nurses, the service was not planned to meet the ongoing needs of these patients. The environment of the short-stay areas did not support effective care for patients accommodated there, which included patients with mental health illnesses.”

Carolyn Jenkinson, the CQC’S head of hospital inspection, said: “We identified several areas in the emergency department that the trust needs to address as a matter of urgency.

“Patients were frequently accommodated in non-clinical areas, including corridors, which didn’t protect people’s privacy and dignity.”

Last December the regulator said surgery at the hospital was “inadequate”. In the new report, the watchdog said patients sometimes had emergency surgery postponed up to seven times.

Some people waited up to 21 days for emergency surgery, with long delays leading to complications such as sepsis, the report said.

George Findlay, chief executive of the trust, said: “We recognise there is more work to do and we are doing it. We are successfully recruiting new people to our teams and filling our staffing gaps.

“We have secured investment and are finalising a business case to improve the layout and functionality of the emergency department at the RSCH and are continuing to build on the improvements we have made in all areas. Some issues take longer to resolve than others, but I want people across Sussex to know that when they come to a UH Sussex hospital, we will do all we can to provide the safe, high-quality, effective care they expect.”

‘The environment of shortstay areas did not support effective care for patients with mental health illnesses’