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University Hospitals of Morecambe Bay Foundation Trust

CQC issues trust with urgent warning to increase A&E staffing


A hospital trust in the north west has been issued with an urgent warning to improve “crisis” staffing levels in accident and emergency by the Care Quality Commission.

The move follows a CQC inspection at Royal Lancaster Infirmary, which is run by University Hospitals of Morecambe Bay NHS Foundation Trust.

A CQC statement issued this afternoon says Morecambe Bay must do more to improve standards of care “or face further action”.

The report comes just months after a damning CQC report on the trust’s maternity services and coincides with a separate warning from the foundation trust regulator Monitor that it would be taking action to “strengthen the leadership” at Morecambe Bay.

Debbie Westhead, North West regional lead for the CQC, said: “An unannounced inspection of the A&E department just before Christmas raised real concerns about staffing levels – staff themselves told our inspectors that these were ‘at crisis level’.”

She added: “The advice CQC gave earlier this month still holds - local people should continue to use accident and emergency services if they need to. However, we are telling the trust in very clear terms that they must urgently address their staffing issues to make sure that the department is safe going forward.”

A Monitor spokesman said: ““Monitor will be taking action to strengthen the leadership of the trust. We will be making an announcement soon about what form our action will take.”

CQC is looking in-depth at the care patients receive when they arrive at the hospital for emergency care, and what happens to them subsequently. The latest warning notice is not the outcome of this investigation, which is ongoing, but has been issued in response to specific issues around staffing identified during an unannounced inspection.

The inspection of the A&E department at the Royal Lancaster Infirmary took place on 21 December, with subsequent examination of staffing records.

CQC inspectors found that staffing levels did not always meet the needs of people using the department.

An examination of shift reports completed by nursing staff for December revealed a number of concerns including:

  • On 6 December, three of the registered nurses on shift were occupied in resuscitation bays, leaving only one nurse in the main department for medication administration
  • On 9 December, by 23.00 hours, the department was ‘blocked’ and only one resuscitation bay was available
  • On 15 December, the corridor was full with people awaiting attention and assistance. The shift report showed 11 four-hour waiting time breaches and five six-hour breaches.
  • On 17 December, no cover was provided for a registered nurse who was off sick
  • On 20 December, patients were waiting in the corridor and the staff shift reports stated that staff were unable to complete all the paperwork required clinically – staff were drafted in from wards to help.
  • Staff told the CQC: “often staffing is at crisis level” 

Related files

Readers' comments (9)

  • tinkerbell

    On 17 December, no cover was provided for a registered nurse who was off sick

    Didn't need to be sherlock to guess that the 17 december was probably a weekend. Couldn't the managers have come in to cover the shift? Of course not, probably told as i have often been told 'just do the best you can', really thanks for the advice i hadn't thought of that.

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  • doing the best you can when you have one or more emergencies on your hands, thanks a lot for the patients who may be in a life - death situation and may die needlessly if they are not given the care and attention they require and rapidly. It also goes without saying the stress this puts on staff who are held responsible as soon as anything goes wrong.

    the problem is that highly qualified experienced staff have been got rid of and only now some nincompoops with their handbags and clipboards have realised that there is a shortage. if the shortfall is made up at all the risk is that it will be by less experienced staff. Surely people realise that to help the sick it does actually require adequate qualifications and experience it is not just a question of dishing out a cup of tea and a few pills ordered by a doctor.

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  • tinkerbell

    Anonymous | 3-Feb-2012 12:48 pm
    the problem is that highly qualified experienced staff have been got rid of and only now some nincompoops with their handbags and clipboards have realised that there is a shortage.

    NINCOMPOOPS they truly are, but look at the great salaries they are being paid for their 'nincompoopery'. Couldn't see a bucket on a snooker table let alone find their way through a fecking door.

    Meanwhile whilst our pulses are racing at 109(i checked mine recently) trying to deal with all kinds of disaster at a weekend what thought do they have for resolving anything quickly, just a repeat performance on another occasion, a pantomime 365 days of the year, starring NHS nurses on the frontline keeping it all together for the management and saving their sorry arses from litigation.

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  • Tinkerbell, what can one say? Will it ever improve. Perhaps one should just apply for a job as a Nincompoop too although I fear we would not be accepted on grounds of being over qualified, with too much experience and well developed common sense and possibly an IQ which is too elevated, oh, and too honest as well, and all this despite our modesty. I rather fear we would not fit in although their NICE and attractive salary would help pay the utility bills.

    Come to think of it, since NICE are so expert at rationing and causing undue suffering to some patients perhaps they should take over the salaries and wages department for senior execs and managers.

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  • tinkerbell

    Anonymous | 3-Feb-2012 2:32 pm

    I fear there is nothing more that can be said that hasn't already been said. I've been bashing away at the common sense approach for over 25 years now and am exhausted. I think i would like a go at nincompoopery for a while but then maybe not as patients lives are at stake. Maybe a job outside of nursing in a circus perhaps as clown, where i wouldn't hurt anyone. Let you know when the circus is next in town and we can join.

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  • nincompooping earns so much money one could envisage early retirement and nincompoop off to some sunny climes leaving the patients in peace although it would be sad to face the risk of a guilty conscience at their expense and leave them in what could be an extremely dangerous lurch! but alas, I fear that is more the responsibility of the government than a personal one.

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  • tinkerbell

    alas i think all the nincompoop posts have been filled. Nicompoop Midwifery Council, Nincompoop Tory Party, Royal College of Nincompoops, CQC need a mention and any others that i have forgotten please add.

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  • The issue of not covering staff who are off sick happens all the time. Sometimes you get offered an HCA as a pair of hands, but there is only so much they can do. It is so unsafe a lot of the time, that I hope that none of my family, friends or self have to come into hospital as I would be very worried about them if they were really poorly.

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  • Funny how our management are in a flap about CQC inspections worried that someone will show up and we won't all know where the evidence is kept - rather than concerned to make sure that staffing levels are as they should be and that services are in good shape. It is such a nonsense that trusts actually employ CQC leads rather than more staff to deliver care.

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