Seven nurses have resigned in just two months from a trust’s under-pressure accident and emergency departments in the Midlands, with at least one flagging patient safety concerns.
Shrewsbury and Telford Hospital NHS Trust confirmed the resignations and that one of the nurses had expressed concerns about safety within the department during an exit interview.
“One nurse who recently left her position in A&E did raise concerns about safety”
Trust board papers published this week stated that throughout June and July there had been five resignations at the Royal Shrewsbury Hospital and two at the Princess Royal Hospital.
These comprised one band 6 and four band 5s at the Royal Shrewsbury and one band 6 and one band 5 at the Princess Royal.
The papers noted that eight new starters were expected to be commencing in post in September, though it did not describe their banding level.
“Whilst this is positive, there will be an impact upon the skill mix of the departments through losing experienced staff,” warned the board documents.
The report highlighted that nurse staffing levels were a “concern” because it meant the trust had to use meant high levels of temporary agency staff.
“Over the last four-week period an average of 44% agency usage has been required. On some shifts recently there has been 75% agency versus 25% substantive,” said the Services under the Spotlight report.
“The fragility of our A&E departments is well known”
It added: “Both ED’s now have permanent practice development nurses to support the development of the nursing teams and co-ordination of the department however they are regularly pulled into clinical roles due to current staffing gaps.”
The two departments are among a “number of services currently provided by the trust that are considered fragile due to workforce constraints which impact on service delivery”, noted the report.
The trust is currently going through a consultation on the reconfiguration of its A&E, which will see the majority of emergency services move to the Royal Shrewsbury Hospital.
Last month, regional directors at NHS Improvement called on neighbouring trusts to provide Shrewsbury and Telford with clinical support for its emergency department.
However, none of them could help due to their own work pressures, according to papers published by Shropshire Clinical Commissioning Group.
“We have raised concerns jointly with the trust with NHS Improvement and NHS England”
Trust chief executive Simon Wright said: “A risk review was recently carried out at the request of both CCGs and the trust. The review looked at a number of issues including workforce capacity.
“There have been long-term issues around the shortage of A&E staff, including consultants, middle grade doctors and nurses, which haven’t been resolved despite recruitment efforts,” he said.
“One nurse who recently left her position in A&E did raise concerns about safety,” he said. “A&E has managed to keep open thanks to the dedication of the staff trying to cover shifts, but this is just not sustainable.
Mr Wright added that the trust was “working hard to recruit additional nurses and in September the Trust will see 63 new nurses and nurse associates join”.
Nigel Lee, the trust’s chief operating officer, said: “The trust is continuing talks on the best way of keeping patients safe in the event of fragile services becoming unsustainable.
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“The fragility of our A&E departments at the Princess Royal Hospital in Telford and the Royal Shrewsbury Hospital is well known, having been discussed by our own board and in meetings with our partners, as well as being the subject of a great deal of coverage in the media,” he said.
Dr Julian Povey, GP clinical chair at Shropshire CCG, said: “We take these concerns very seriously and are working closely with Shrewsbury and Telford Hospital NHS Trust to monitor the safety of the A&E department.
“We have raised concerns jointly with the trust with NHS Improvement and NHS England as to the sustainability of staffing across the two A&E Departments,” he noted.
“Among the actions are daily assessments of staffing, a process which the CCG’s nursing director is involved,” he said.
He added: “We are currently going through a public consultation on the reconfiguration of the Royal Shrewsbury Hospital and the Princess Royal Hospital A&E’s, which aims to improve the way our hospital services are delivered by providing a long term, sustainable solution.”