The standard of care at Norfolk's largest hospital has been criticised by inspectors after they carried out an emergency review.

The Care Quality Commission launched its investigation of the Norfolk and Norwich University Hospital after it was made aware of concerns for the safety of patients being treated there.

The watchdog rated the medical care at the site as "requiring improvement" - the second lowest ranking available.

The inspection was carried out in November, before the worst of the winter NHS pressures were felt at the site.

In recent weeks, there have been reports of people waiting up to 12 hours to be admitted to the hospital.

Among issues highlighted by the CQC report were that:

  • patients were being treated in corridors,
  • when they rang call bells for attention, they were not answered
  • a shortage of nurses and healthcare assistants
  • staff were exhausted and could not always respond to patients' nutritional, hydration and pain-relief needs.

Norwich Evening News: One patient took this photo of her bed at the NNUH in a ward where extra beds are being squeezed in to increase capacity

Much of the inspectors' concern was on the impact of measures introduced to increase capacity at the hospital more than a year ago, by adding extra beds to wards.

It meant that wards designed for six beds were reconfigured to accommodate seven.

The report states: "The use of additional beds in bays was impacting on the space available to provide care and on privacy and dignity of patients.

"Patients could not always reach call bells and staff were not always able to respond quickly when called."

The report comes at a time when the wider NHS is battling unprecedented challenges posed by shortages in the care sector, demands on services and high staff turnover.

Antoinette Smith, the CQC's head of hospital inspection in the east, said: "Although the trust knew how this challenge affected it and was taking steps to reduce the risk this posed to people using its medical care, a lack of staff meant it couldn't consistently meet people's needs in the service.

"The pressure the service was under was increased by a lack of available places elsewhere for people to receive respite or step-down care.

"This meant people stayed on the service's wards longer than they needed and people needing the service couldn't be admitted without increasing the number of beds beyond what it is designed to accommodate."

Norwich Evening News: Sam Higginson, chief executive of the Norfolk and Norwich University Hospital.

Sam Higginson, chief executive at NNUH, said: "The report summarises the challenges we face with extremely high demand, a high number of patients in our hospital who no longer require an acute hospital bed.

"I'm particularly pleased that the CQC highlighted a culture of openness and honesty throughout all levels of the organisation and were impressed with the care and compassion of our teams.

"We recognise the areas for improvement raised by the CQC and we are developing focused action plans to improve safety and efficiency.

"We are working with our teams and system colleagues to reduce operational pressures and we are absolutely determined to improve."

 

Areas of concern

The report highlighted a number of challenges being faced by the hospital. These included:

  • A shortage of nurses and healthcare assistants undermined care and treatment,
  • Staff morale was low, with workers complaining of feeling exhausted and stressed,
  • Patients being cared for in additional beds did not receive the same level of privacy as others,
  • Patients were often moved between areas without clear medical reason.

 

Praise for staff

Despite the concerns, staff were praised in several areas. These included:

  • Patients said staff treated them well and with kindness,
  • Patients were put at the heart of everything staff did,
  • Staff tried to be discreet and took time to interact with patients in a respectful way.