Hospital bosses have been told that two Lincolnshire emergency departments need “urgent improvements”.
Care Quality Commission officials said that both Lincoln County Hospital and Boston Pilgrim Hospital A&Es must improve after inspections prompted by patient safety concerns.
Inspectors rated the emergency departments as “inadequate” overall following visits last month.
United Lincolnshire Hospital Trust apologised and said it had “fallen short of what patients would expect”.
The CQC took enforcement action on the trust which means it must adhere to conditions including:
- Ensuring patients are seen within a specified time frame
- Appropriate systems are in place if a patient’s health deteriorates following admission
- Enough skilled staff are always on duty
- Patients are treated with dignity and respect
Ted Baker, chief inspector of hospitals at the CQC, said the trust has “a lot of work to do” to reduce pressures on the departments.
“When we visited the emergency departments at Pilgrim Hospital and Lincoln County Hospital, we saw several areas where improvements must be made, this included the requirement for urgent actions to be taken at Pilgrim Hospital,” he said.
“Ambulance handover delays remained a challenge, with some patients experiencing delays of more than 100 minutes from arrival by ambulance to being handed over to trust staff for commencement of care and treatment.
“Patient flow must be coordinated across the whole emergency care pathway to ensure patients receive care and treatment in a timely way.
“The A&E department at Pilgrim Hospital was overcrowded and too small for the number of patients attending and leaders lacked the skills to run the service effectively.
“This impacted on how patient flow could be managed. It also resulted in patients being treated in corridors or the central space of the department and having their dignity compromised.”
Andrew Morgan, chief executive for ULHT, said the trust was making significant efforts to improve its emergency care.
“Following the release of the latest CQC inspection report into the emergency departments at Lincoln County Hospital and Pilgrim Hospital, Boston, we would firstly like to apologise,” he said.
“We recognise that the level of care provided, and the experience of our patients, has fallen short of what we, and our patients, would expect.
“We would like to reassure our patients that we have been making significant efforts to improve the staffing, systems and processes in the departments to ensure that we can provide the best quality emergency care to the people of Lincolnshire.
“Whilst the report acknowledges the amount of pressure that both departments have been under over the last few months, it unfortunately identifies a number of areas where inspectors felt that significant improvements need to be made.
“We know the challenges we face in relation to the lack of space in the departments, recruitment, our reliance on bank and agency staff, delays in ambulance handovers and seeing and treating patients in a timely manner.
“It is also clear that we need to focus on leadership, staff training and competencies, staff engagement and addressing workforce inequalities going forward.”
Lincolnshire’s A&Es under pressure
Emergency departments in Lincolnshire have come under “significant pressure” in recent months.
In the past few months, the trust has told patients to avoid Lincoln A&E due to it being “exceptionally busy” and GPs increased the number of emergency appointments to help cope with demand.
ULHT saw a “significant increase in very poorly patients” at the department in November, with some waiting as long as 12 hours to be seen.
The trust has not hit the four-hour standard set for waiting times in A&E for more than half a decade.
In an effort to ease the pressure, hospital bosses want to extend the units at both Lincoln and Boston.
Following a visit from Prime Minister Boris Johnson last August, a total of £21.3 million worth of capital funding was secured for Boston A&E.
Trust officials said the department at Boston was half the size it needed to be in order to cope with demand.
A similar bid of around £20 million has been made to government to increase the capacity of Lincoln A&E.
Meanwhile, the trust finds itself in double special measures for both quality and finance.
Last week, in an interview with the Local Democracy Reporting Service, Mr Morgan said he wants the organisation to improve and become “outstanding” by 2025.
SUBSCRIBE TO LOCAL DEMOCRACY WEEKLY, our exclusive email newsletter with highlights from our coverage every week and insights and analysis from our local democracy reporters.