Raft of changes due at Princess of Wales Hospital


Back on September 5th, Abertawe Bro Morgannwg Local Health Board (LHB) held their monthly meeting.

Several urgent changes were outlined following a series of publicised incidents and performance issues at Bridgend’s Princess of Wales Hospital.

It’s the third item on the meeting agenda (pdf p7-11).

The Problems

Several major ones reported in the local and national press include:

  • The death of an 82-year old following poor care, resulting in a rebuke from the Public Services Ombudsman and £1,000 in compensation.
  • The case of an elderly woman who was poorly treated at both PoW Hospital and NPT Hospital three times between August 2010 and her death in November 2012.
  • Three arrests of nurses following the faking of patient notes.
  • Serious concerns raised about how Abertawe Bro Morgannwg LHB deal with complaints, described as being “chaotic”and “in meltdown”.

Other problems outlined at the meeting include:
  • Mortality rates were adjusted upwards from the reported figure in March 2013, rising from 113 to 118 (where normal is considered 100), with higher mortality rates in unspecified specialities. This – nominally at least– means the PoW Hospital probably has one of the the highest mortality rates of the Abertawe Bro Morgannwg hospitals.
  • Unspecified “blood glucometry incidents” that are under investigation.
  • Staffing difficulties in Accident & Emergency (a problem across Wales & the UK).
  • Only 4 out of 11 recorded deaths resulting from C.difficile infection were reported to the Welsh Government, and on top of that there’s been an overall increase in the number of C.difficile infections at the hospital.

The Changes
  • With respect to the C.difficile infections, control procedures were put in place immediately and corrections have been made to mortality reporting procedures.
  • A special Quality and Safety Improvement Programme has been set up – with fortnightly updates – in order to keep a close eye on : patient care, patient safety, the blood glucometry incidents and things like clinical leadership etc.
  • An outside Advancing Quality Alliance from NW England will undertake a thorough review of quality and safety at the hospital in order to reduce mortality rates. They should report back by December 2013.
  • Changes to the nursing workforce come fully into force from November, including :
    • a new Head of Nursing.
    • a more visible leadership role for nurses in charge of wards.
    • making sure patients are visited by a nurse three times per shift.
    • changes to ward shifts to make sure a Ward Sister“is available every evening in Bridgend.”
    • a pilot ward administrator role to take administrative duties away from the Ward Sister.
    • 31 extra full time nurses started work this month, reducing the reliance on agency nurses.
  • Two wards were found to have a “high level of incidents and complaint” and their management has been restructured.
  • The Clinical Decision Unit (CDU) has experienced problems, so they’re developing a new delivery model for emergency medicine that should improve things.
  • A review of complaints over the last 18 months will identify common themes and trends that require further action.
 

 

The Fallout

Aside from how the health board deal with complaints and the outcome of the patient records investigation by South Wales Police, it’s fair to say ABM have reacted quickly. It’s clear they’re taking action on this even if it’s wrapped up in management speak.

Hanging over all this too is the outcome of the South Wales Programme consultation – recently pushed back until December, which might cause even more uncertainty.

Needless to say, the timing of these these revelations isn’t good, seeing as the hospital’s under the spotlight because of those proposed centralisations of specialist services – in particular high-end A&E services.

All these errors could be a sign that staff morale has gone through the floor, not only due to the bad press the hospital’s been getting because of these incidents, but also the long-standing issues resulting from poor staffing levels, sluggish performances and the fact we’re heading into winter when things get even busier.

So, although it’s fair to say there’ve been some serious mistakes made, it’s not worth kicking them when they’re down and dwelling on it as long as the changes produce results.

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Owen