Patients left waiting on trolleys for four days due to ‘unsafe’ staffing levels, report finds

Patients were left on trolleys for up to four days at a major NHS hospital where whistleblowers raised concerns over “unsafe” staffing levels, it has emerged.

In a scathing report, the NHS safety watchdog said it found patients waiting on trolleys, in corridors and outside nursing bays at Good Hope and Heartlands hospital, run by the scandal-hit University Hospitals Birmingham NHS Foundation Trust.

In one incident flagged by the Care Quality Commission, a patient’s skin ulcers had grown significantly worse while they waited for four days on a trolley without an appropriate mattress. At the time of the inspection, most patients had been waiting for more than two days on trolleys, according to the CQC.

The inspection took place in December, after concerns were raised by patients and families over care. The CQC said staff told inspectors they’d been left in “unsafe situations” due to poor staffing.

They also said that low staffing and continued pressures on medical assessment wards meant they had been forced to leave patients unsupervised.

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The inspection report comes after an independent review of patient safety within the trust warned a “corrosive” and bullying culture was putting safety at risk. University Hospitals Birmingham is also facing two further independent reviews of its culture, which were launched after media reports from BBC Newsnight exposed allegations from former staff warning the trust has a “toxic” culture.

During the latest inspection, the CQC found the hospital was using a model – rolled out by NHS England to several trusts across the country – that sent patients from A&E to assessment wards every few hours, regardless of space.

This model has been rolled out under national direction in a bid to free up space in A&E and reduce ambulance handover delays.

According to the CQC report, staff in the hospital’s medical wards warned managers that the model had led to patients being left in corridors or sitting on chairs near nursing stations.

The report said: “Staff highlighted safety concerns over patients who were deemed appropriate to be moved under this process, however, were later identified to be significantly unwell. Staff had escalated their concerns about this process however due to the demands on the service, the process continued to be used.”

In a bid to increase beds during winter, the trust had converted areas of the hospital, such as a gym, into wards. But the model meant patients were left on assessment unit corridors waiting to go onto wards for up to 50 hours, the CQC said.

The safety watchdog also flagged reports of bullying within the trust’s medical services and low morale among staff, driven by worker shortages.

Patient safety issues included elderly patients suffering falls as nurses were unable to provide one-to-one support.

The report added: “Staff told us even when concerns were raised, nothing appeared to be done and they were ‘left to get on with it’.”

It said staff from other departments even sought out inspectors to raise their concerns, warning they’d been forced to leave wards they worked on as pressures had put them in “unsafe” situations on a “daily basis.”

The CQC has now issued the trust with a formal warning notice over its staffing levels, meaning it will be required to address concerns before further inspections or face further regulatory action.

Jonathan Brotherton, chief executive at University Hospitals Birmingham NHS Foundation Trust, said: “I would like to thank the CQC for their inspection; their findings have highlighted issues that we are working on to improve the care we provide for our patients, as well as the work we are doing to grow the support we provide for our workforce.

“Importantly, the inspectors noted that our teams are working extremely hard under pressure and we are pleased that it was recognised that our teams treat our patients with kindness and compassion. This is something that I would also like to echo.

“Our staffing levels, like much of the NHS, are challenged and we are continually working to address this. We have a strong programme of work to support values-led recruitment, with a clear commitment to bring more brilliant people into our organisation, to continue to provide excellent care.”