Crisis mental health patients in ‘short stay area’ for three weeks

A CQC inspection found that patients in crisis were kept waiting in an area with no natural light, tv, radio or shower

2nd August 2022 about a 3 minute read
"We recognise there is more work to do and we are doing it. We are successfully recruiting new people to our teams and filling our staffing gaps." George Findlay, chief executive, University Hospitals Sussex Foundation Trust

Patients in Brighton experiencing a mental health crisis have been kept in a “short stay area” of a hospital emergency department for up to three weeks, according to a report from the Care Quality Commission (CQC).

The short stay area of the emergency department in Royal Sussex County Hospital,  which is part of University Hospitals Sussex Foundation Trust,  has no natural light, no TV or radio and only a toilet and washbasin, with a shower available on a neighbouring ward, the CQC said. The average length of stay was 52 hours, according to trust data, but staff reported the longest stay as being up to three weeks.

The patients were reviewed daily by a mental health liaison team from another trust while they waited for a mental health bed to be found.

The CQC report said: “The needs of patients in the local community with mental health conditions were not fully met. They were accommodated for lengthy periods of time in an environment that did not fully meet their needs and by staff who may not have the skills to care for the patient.”

The urgent and emergency services, which were inspected after concerns were raised with the CQC, were downgraded from “good” to “requires improvement” as a result of the inspection.

When inspectors visited the trust in April, they found a tarpaulin was used to separate the emergency department into “red” and “green” areas, and 12 patients were either in corridors or accommodated at the front of patient cubicles. Between 1 February and 16 April, there were 67 days when more than 18 patients had been accommodated in corridors.

Staff had not received training in essential skills

The CQC identified other problems in its inspection. It found that between October and March, 180 patients waiting for general emergency surgery had it postponed, in some cases up to seven times, while 32 emergency trauma surgery cases had between one and four postponements. Patients waited up to 21 days for emergency surgery, with waits outside of recommended timescales leading to complications such as sepsis, the report said.

Not all the emergency department staff had completed all the trust-mandated training in key and essential skills, and not all staff had received appraisals, the report said. It found that the  “use of the environment did not always support keeping people safe” and that  patients “were frequently accommodated in non-clinical areas.” The environment “posed an infection risk as it could not be cleaned effectively.”

UHSussex chief executive George Findlay said that, since returning to the trust two months ago, he had been “extremely impressed by the efforts and commitment of colleagues in all our hospitals to always provide the highest standards of patient care despite the pressures on our services.”

Noting that the CQC had recognised improvements to maternity and surgery since a previous inspection in September 2021, he added: “We recognise there is more work to do and we are doing it. We are successfully recruiting new people to our teams and filling our staffing gaps. We have secured investment and are finalising a business case to improve the layout and functionality of the emergency department at the RSCH and are continuing to build on the improvements we have made in all areas.

“Some issues take longer to resolve than others, but I want people across Sussex to know that when they come to a UHSussex hospital, we will do all we can to provide the safe, high quality, effective care they expect.”

FCC Insight

This report from the CQC illustrates just how much hospitals are not meeting demand. Rates of mental ill-health have soared since the pandemic, and it is clear that the NHS is, in many areas, struggling to cope. It should never be the case that people experiencing a mental health crisis should have to wait days or weeks in an emergency department’s short-stay area. More community support for people with mental health problems and better resources for hospital emergency departments are both needed as a matter of urgency.