A dead patient was left on a ward for hours and another died after a fall at a hospital which has suffered staffing issues during the Covid-19 pandemic.
A new report into care at University Hospitals Birmingham NHS Foundation Trust, one of the largest in England which has been hit particularly hard by the latest coronavirus wave, has laid bare the impact of the pandemic.
A series of Care Quality Commission (CQC) reports highlight how a patient who died was left on a ward for almost five hours and was not transported away due to low staffing levels.
Inspectors also highlighted issues surrounding infection control after hearing reports of patients without Covid-19 being placed on wards where there were Covid-positive patients.
CQC inspectors said deceased patients at Good Hope Hospital in Sutton Coldfield, one of the hospitals run by the trust, were “not always transported from the wards in a timely manner”.
“On ward eight, a patient had passed away at 6.45am, at 11.35am the patient still had not last offices completed or been transported from the ward due to low staffing levels,” the report states.
“This was reported by several staff members and it caused them distress.”
The document also highlights how another patient died and others suffered harm after potentially avoidable falls.
The inspection report states: “We were provided with examples of potentially avoidable falls due to low staffing numbers.
“On ward 11, a patient fell and passed away after sustaining an injury.
“At the time of the fall, the ward was short-staffed, and all staff were busy with other patients.
“An investigation report was produced as a result which highlighted staffing as a concern.”
Other findings include:
– The service did not have enough nursing staff to keep patients safe. Some nurse-to-patient ratios were 1:17 at the time of inspection.
– Staff told inspectors about patients who had contracted Covid-19 while admitted to hospital, and felt this was linked to the “site management and allocation of patients to wards”. For example, some patients who were screened as Covid-19 negative were put on Covid positive wards.
– On one ward, which was visited during the second day of inspection, there were the appropriate number of nurses on the rota which was described as a “luxury”, despite the number of healthcare assistants on duty that day falling short of pre-planned staffing levels.
– Staffing shortages meant that some patients had to wait to be supported to eat meals.
– Staff frequently worked “hours” beyond their 12 hour shifts to ensure patients were safe.
– Some relatives of patients had “turned up directly to the hospital to complain” after raising concerns about not getting timely updates about their loved ones.
– Some relatives had complained that patients were discharged “in a worse condition than when they were admitted”.
– Concerns were raised about the cognitive decline among patients with dementia – with relatives unable to visit and staff being so busy they were mostly being restricted to providing essential day-to-day care and treatment, not mental stimulation.
Inspectors also raised concerns about nurse staffing at the Birmingham Heartlands Hospital and at Queen Elizabeth Hospital Birmingham.
CQC has made recommendations for the trust, including ensuring that nurse staffing is adequate to keep patients safe and improvements in venous thrombosis embolism care.
“At the time of the inspections, which took place on 2 and 9 December 2020, the Trust and our amazing staff were 10 months into a pandemic response with over 450 Covid inpatients on the days the inspections took place, rising to 1,054 Covid inpatients during January.
“The effort of our staff to provide care to what is now well over 11,000 Covid inpatients, during the most difficult period in the history of the NHS, has been and remains quite extraordinary. It continues to be our focus.”