Dear Sir 

I WAS concerned by the response of the Princess Alexandra Hospital Chief Executive as it seemed to me that he played down the seriousness of the CQC’s findings in their latest inspection report. For whilst the overall score for the hospital was found to be Requires Improvement and the overall Caring Services score was Good. The Accident and Emergency Services were found to be Inadequate.  

The Your Harlow article PAH: Report grades A and E inadequate after inspectors intervened over deteriorating patients, details some of the concerning incidents the CQC Inspectors witnessed during their visits. 

Following their visit the CQC told The Princess Alexandra Hospital Trust that it must take following action to bring services into line with legal requirements.

• The trust must ensure that governance, risk and assurance systems are effective and embedded throughout the trust. (Regulation 17 (1)(2)(a)). Urgent and emergency care 

 • The trust must ensure there are sufficient numbers of suitably qualified, skilled, competent and experienced nursing staff at all times to meet the needs of patients within all areas of the Emergency Department at the Princess Alexandra Hospital (Regulation 18 (1))  

• The trust must operate an effective system which will ensure that every patient attending the Emergency Department at the Princess Alexandra Hospital has an initial assessment of their condition to enable staff to identify the most clinically urgent patients and to ensure they are triaged, assessed and appropriately streamlined. (Regulation 12 (1)(2)(a)) 

 • The trust must devise a process and undertake a review of current and future patients clinical risk assessments, care planning and physiological observations, and ensure that the level of patients’ needs are individualised, recorded and acted upon. This must include, but not limited to skin integrity, falls, and mental health assessments. (Regulation 12(1)(2)(a) )  

• The trust must ensure that it implements an effective system with the aim of ensuring all patients who present to the emergency department at the Princess Alexandra Hospital patient observations are completed within 15 minutes of arrival and as appropriately thereafter in line with trust policy. (Regulation 12 (1)(2)(a)) 

 • The trust must ensure that the paediatric mental health room is fit for purpose and meets the standards set out in Facing the Future, Standards for Children in Emergency Care Settings. (Regulation 13 (1)) 

 • The trust must ensure that there are safe toilet facilities for adult patients presenting with mental ill health. (Regulation 13 (1)) 

 • The trust must ensure that there is a clear record and oversight of patients being admitted to clinical decisions unit. (Regulation 17 (1)(2)(a)). 

This may sound harsh given the Covid pandemic but in both 2019 and 2020 the Emergency Department was rated by the CQC as Requires Improvement it now rates as Inadequate. So will the Chief Executive tell us which of the legal requirements stipulated by the CQC have now been complied with? Which are still are outstanding? Why are they are still outstanding and how and by when will the issues be addressed. 

In conclusion, this letter should not in any way be construed as critical of front-line staff who have struggled and continue to struggle with huge pressures and demands on their services, but rather as a plea for the management support, systems and resources to be put in place to enable the staff to function in a safe and effective way and for the public to know they will receive a safe, effective and caring service.

Regards

Cllr Tony Edwards