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Out-of-hours hospital care in Wales is ‘inadequate’

Soaring complaints and poor practice revealed

Jo Carlowe

Tuesday, 08 March 2016

Out-of-hours hospital care in Wales is inadequate and needs a systemic review.

In a damning report,* published today, the Public Services Ombudsman for Wales, describes “patterns of…complaints and poor practice”.

“During the last five years complaints and enquiries have increased 105% while health complaints have escalated 126% during the same period,” states ombudsman Nick Bennett.

A snapshot of 12 cases investigated by the watchdog over a five year period, revealed, among other failings, inadequate consultant cover across seven days, delays in medical review and lack of consultant review, lack of senior supervision for junior medical staff and a failure to meet standards of care and follow nationally agreed guidelines. In addition, medical record keeping was found to be inadequate, and poor communication between members of staff and between staff and patients or their families, was noted. 

To improve out-of-hours care, the Ombudsman recommended an independent systemic review, improved supervision of junior staff, prioritisation of inpatient care and improved handovers.

The 12 case studies included one in which an elderly, nutritionally deficient patient had to wait more than 40 hours over a weekend until an attempt was made to insert a NGT to provide appropriate nutrition. 

Mr Bennet, spoke of variation in practice not just between hospitals but also between wards within hospitals. 

In a foreword, Mr Bennet said: “I am only too aware that there is an Assembly election in May and the NHS will be a key issue in that campaign… the sole purpose of this report is to ensure that lessons are learned from the complaints I have considered. I am therefore highlighting issues for future considerations for public sector bodies which I believe are worthy of deliberation.”

Health Minister Mark Drakeford, stressed that the report was based on 12 cases, of which “a number of those predate this Assembly term.” He said it was important for best practice in the NHS to be shared. 

* Out of hours: Time to care. Public Services Ombudsman for Wales, March 2016.

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