- NHS hospital
Medway Maritime Hospital
Report from 14 November 2024 assessment
Contents
Ratings - Urgent and emergency services
Our view of the service
The Trust provides urgent and emergency services at Medway Maritime Hospital. The emergency department (ED) has a resuscitation area, a majors areas, a rapid assessment unit, urgent treatment centre and clinical decision unit. There is a separate waiting area for children attending ED. Due to concerns received about safe care and treatment of patients, we commenced an off-site assessment of the service on 7 February 2024 together with an on-site assessment on 21 February 2024. We used our focused assessment methodology for this assessment. We did not look at all quality statements for all key questions. We found breaches of Regulation 10, 12, 15, 17 and 18 of the Health and Social Care Act (Regulated Activities) Regulations 2014. The service did not protect the privacy and dignity of patients. Patients experienced long waits in the department before admission to an inpatient bed. The environment within the emergency department was not suitable for the number of people being accommodated and staff did not have clear policies to support them to provide safe care to patients in non-designated care areas. The service did not ensure there were enough suitably qualified nursing staff to provide safe care and treatment to the number of patients in the department. The service did not manage medicines well and patients did not always receive their medicines on time. The service did not ensure all incidents were reported and acted on. Some staff described a poor culture, with staff fearing reprisal for raising concerns and senior leaders not focused on patient care. As a result of these findings, we served a Warning Notice requiring the trust to make significant improvements to the quality of healthcare in the emergency department. However, the environment was visibly clean. Local leaders provided support, and staff were committed to providing care in challenging circumstances. Staff and leaders were proud that partnership working had reduced ambulance off-load times.
People's experience of this service
Many people had a poor experience in the emergency department. Patients and relatives told us about long delays and patients accommodated in non-designated care areas. Patients were not afforded privacy and dignity, and some waited 2 days or more for an inpatient bed. Some patients and families told us they experienced a lack of compassion from some staff. However, other patients told us that staff were compassionate and that they received care and treatment in a timely manner.