People left without timely pain relief, delays in risk assessments and patients’ privacy and dignity being impacted by overcrowding – these are just some of the findings of an inspection of The Grange University Hospital in Cwmbran.
An unannounced inspection of the Emergency Department was carried out by Healthcare Inspectorate Wales (HIW) in October, 2024, two years on from its last inspection. Inspectors identified what was described as “ongoing systemic challenges affecting the consistent delivery of safe care”. It also, however, noted some “positive progress”. Plans have recently been submitted for a temporary building at the hospital to free up beds. You can read more about that here.
The report, released today (January 15) says: “It was disappointing to find that overcrowding in the waiting room and reception area continues to compromise patient privacy, dignity, and access to timely care. This was compounded by delays in patient flow, largely driven by system-wide discharge challenges that have a knock-on effect on the department.
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“Inspectors were concerned about insufficient staff oversight in waiting areas, delays in completing risk assessments, and instances where patients did not receive timely pain relief. HIW asked for immediate improvements to be made in relation to risk assessments, medicine management, and equipment checks.
“Improvements had been made since our previous inspection, including the introduction of an electronic triage system which has helped improve the efficiency of patient triage processes, and ongoing construction of an extended waiting area, which aims to alleviate overcrowding and improve staff visibility.
“While nurse staffing levels remain under pressure, these have stabilised compared to the previous inspection, with less reliance on agency staff and improved retention. Inspectors noted the impact of enhanced training and support initiatives, including a dedicated practice development nurse. Over 85% of staff have completed mandatory training, and systems to capture patient feedback, such as QR codes, are now in place to help improve services.”
The hospital, part of Aneurin Bevan University Health Board, has been beset by problems since opening in 2020, some of which you can read about here. The report from HIW said that “systemic pressures persist”. “There was a persistent high escalation status across the health board at the time of our inspection, with delays in discharging up to 400 patients. Renovation work on the department’s waiting area is progressing but will not be completed until spring, 2025, delaying any immediate relief.
“Inspectors commended staff for their professionalism, compassion, and commitment to delivering care under challenging conditions. However, the department remains under pressure, and systemic issues within the health board and the wider NHS continue to impact the consistent delivery of timely care,” it reads. For our free daily briefing on the biggest issues facing the nation, sign up to the Wales Matters newsletter here
Chief executive of Healthcare Inspectorate Wales, Alun Jones, said: “”This inspection highlights both the dedication of staff working under immense pressure and the significant challenges that remain in delivering safe, timely, and dignified care. We are encouraged by the progress the department is making, but further improvements are urgently needed to address systemic issues affecting patient flow and care delivery. HIW will continue to work closely with the health board to ensure the necessary changes are implemented, so that patients receive the high-quality care they deserve.”
A spokesperson for Aneurin Bevan University Health Board said: “We welcome this report into our Emergency Department at The Grange University Hospital, which recognises the professionalism, compassion, and dedication of our staff, as well as progress made in several key areas.
“The report highlights the sustained pressures on our hospital system, as seen across other areas of the UK, including the high number and complexity of patients attending the department and the impact of pressure on social services leading to some patients spending longer in hospital than their medical condition requires.
“HIW identified areas requiring ‘immediate assurance,’ which were addressed promptly, and we have an action plan for the other recommendations. Work is also underway to help address the challenges around waiting times, capacity and patient flow, with an extension of the waiting area due to be completed this spring, and a new discharge lounge due in March. We expect both of these initiatives to significantly improve patient experience in our critical care centre.
“We value HIW’s independent assessments, which help us learn and develop our services further. We apologise to patients whose care has fallen below the standards we strive for and to those experiencing delays. We remain incredibly grateful to our staff, who continue to work tirelessly under significant and sustained pressure.”
The Welsh Conservative health spokesman, James Evans MS, said: “The situation at the Grange Hospital and hospitals across Wales is completely unacceptable. If the Welsh Labour Government does not get to grips with discharge delays, by empowering the social care sector, and better triaging of patients then these problems will get worse, not better. We need a comprehensive social care plan for Wales that addresses the huge issues facing the sector. The only way we are going to see better patient flow through hospitals is ensuring that people who are medically fit are discharged in a timely manner.”