Shropshire hospitals trust fined over A&E assessment breaches

The Care Quality Commission (CQC) said it has issued a fixed penalty notice to the Shrewsbury and Telford Hospitals NHS Trust (SaTH) as it missed the national target.

The care watchdog also said the trust failed to implement a system to ensure that all children who left the emergency department without being seen were followed up in a timely manner.

In response, the trust said improvements have been made in recent weeks resulting in assessment times of nine minutes at the Princess Royal Hospital in Telford and 13 minutes at the Royal Shrewsbury Hospital.

It also said more nurses had been successfully recruited.

The fine followed inspections made on April 18 and November 29 last year resulting in the CQC imposing seven conditions on the trust’s registration.

Then, following information submitted from the trust it was identified that these conditions had been breached at both hospitals between April 18, 2019, and 29 September, 2020.

The CQC's Chief Inspector of Hospitals, Professor Ted Baker, said: “The trust has not responded satisfactorily to previous enforcement action regarding how quickly patients are assessed upon entering the urgent and emergency department.

“We have issued a penalty notice due to the severity of the situation and to ensure the necessary, urgent improvements are made.

Monitor

“It is essential that patients are seen in a timely way when they arrive at an emergency department; failure to do so could result in deteriorating health, harm, or even death, which is why national guidelines exist and must be followed.

“We will continue to carefully monitor the trust to determine whether this drives the required change and will take further action if there is no progress.”

In a statement the trust said: “We have made important changes to our processes in our emergency departments and these, along with a successful recruitment drive, has seen our average triage time reduce over the past few weeks to nine minutes at the Princess Royal Hospital in Telford and 13 minutes at the Royal Shrewsbury Hospital.

“In recent months we have successfully recruited 14 registered children’s nurses and a paediatric emergency medicine consultant to work in our emergency departments. We have also increased the number of Staff Nurses on duty to ensure that an adult and a registered children’s nurse are available at all times to greet our patients and complete a timely initial assessment.

“We are committed to providing the best possible care to all of our patients, their families and carers.”

The seven conditions required SaTH to report the time from admission to triage by a clinician, ensure follow-ups were undertaken for children who were not seen at the department and to report to the CQC what systems were in place for effective management of patients under the age of 18 through the emergency care pathway.

The trust said it was looking to bring in a play therapist to the A&E team and was improving staff support.