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Inspectors note A&E nurse shortage at Kent trust

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A shortage of nurses qualified in the care of children is one of the problems facing the accident and emergency department at Darent Valley Hospital in Dartford, Kent, a report has warned.

In a generally positive first report on services provided by Dartford and Gravesham Trust, England’s chief inspector of hospitals described most services as good and praised an open culture where staff were positive, engaged and very loyal to the organisation.

It noted the trust had “taken action in some areas where staffing issues had been identified, including increased nursing staff levels on some wards”.

Staff and management were open and transparent about the challenges they faced, but there were areas where the trust needed to make improvements, it said.

Inspectors found a number of examples of good practice and shared learning, although in some cases changes after serious incidents took up to 12 months to implement.

The report praised recruitment to address staffing issues, including increased nursing staff levels on some wards, more porters in the pharmacy department and the recruitment of additional midwives.

However, areas were identified where the trust was facing “significant challenges” – most notably in the A&E department, where the number of emergency admissions had increased due to a reduction in other local services.

The trust was found to be managing issues on a day-by-day basis – but inspectors said it was failing to solve the key underlying problems, in particular bed management and capacity, and inappropriate attendance at A&E.

Also in A&E, there were insufficient numbers of nurses qualified in the care of children and a high use of locum middle grade doctors, which had the potential to impact on patients’ safety.

Inspectors said the acute assessment wards were at times mixed sex, a situation that risked compromising the dignity of patients.

“We found that most of the services at Darent Valley Hospital were good,” said Professor Sir Mike Richards, the Care Quality Commission’s chief inspector of hospitals.

Sir Mike Richards

“The majority of patients told my team they were happy with the care and treatment that they had received, and we identified a number of examples of good practice.

“Overall, we found a culture where staff were positive, engaged and very loyal to the organisation, and the staff and management at the hospital were open and transparent about the challenges they faced.

“We did, however, find a number of fairly basic areas in which the trust needed to improve,” he added. “We’d expect people’s privacy and dignity to be respected at all times, and for people to always be cared for in an environment that is designed to meet their needs, by an appropriate number of staff.”

In its recommendations, the CQC ordered the trust to ensure the required number of staff with the correct skills are employed and managed shift by shift.

It should also make certain that patients at Darent Valley Hospital are treated with dignity and respect at all times, especially in the area of the operating department where they are received.


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