A crisis-hit hospital has been told to make urgent improvements after it emerged patients face average waits of more than 27 hours to be admitted to a ward.
The Care Quality Commission (CQC) has rated William Harvey Hospital’s urgent and emergency care as ‘requires improvement’ following an unannounced inspection.
Inspectors, who saw a critical incident declared on the second day of their visit in February, found A&E was operating under severe and sustained pressure.
They also highlighted deeply concerning lapses in patient dignity due to severe overcrowding, including an elderly patient who was left exposed below the waist in a “temporary escalation area” until inspectors intervened.
Another patient was observed undergoing an abdominal scan in a corridor without a privacy screen being used.
While some positive changes were noted, the healthcare watchdog found breaches of regulations relating to safe care and treatment.
The damning findings come less than a year after KentOnline revealed the Ashford hospital was forced to turn its coffee shop into a makeshift ward due to the level of demand.
They also follow a period of leadership turmoil at East Kent Hospitals University NHS Foundation Trust (EKHUFT), which saw the departure of chief executive Tracey Fletcher in May.
The CQC report, published today, highlights how overcrowding also meant staff could not always maintain confidentiality, with private medical conversations taking place where others could overhear.
The chaotic environment led to a severe safety error where a patient’s regular, time-critical insulin was not ordered for three days – a life-threatening risk that was only rectified when inspectors intervened.
The cause of the crisis was poor patient flow, with data showing that over a six-month period, people were waiting more than 27 hours on average to be admitted to an acute medical ward.
These delays were exacerbated by specialist teams failing to respond promptly, with only around a quarter of specialist reviews completed within an hour.
Site meetings during the inspection revealed the severe extent of these bottlenecks, with six patients found to have been waiting in the department for more than 72 hours.
The report says: “We heard from a patient who was in a corridor for more than 24 hours with a suspected spinal injury. Due to delays in treatment and scanning they were unable to get up to use the toilet facilities.
“The patient was very distressed and felt they were not being communicated to well about the delays and their needs were not being met.”
Others described feeling “forgotten” in the waiting room and temporary escalation areas.
One patient told inspectors: “I have been waiting for pain relief for two hours”. Others reported long delays just to get paracetamol.
There were also severe diagnostic delays, with some patients waiting up to 23 hours for a CT scan.
Leaders were also criticised for not consistently providing sufficient capacity overnight, contributing to higher numbers of people leaving without treatment between 8pm and 8am.
The report says: “The department remained crowded in all areas and patients remained overnight in chairs and trolleys. For example, we saw on day two that there were three patients over the age of 80 who were in chairs for several hours awaiting a decision to admit.”
It adds: “Several patients felt that sleep overnight in escalation areas was impossible as the lights were not switched off and there was constant noise, people banging into their trollies as they passed by and no privacy.”
The report highlighted the physical dangers of the cramped conditions, noting bed rails “having to be put down to allow two trollies to pass each other”. Families also described the corridors as a “terrible experience”, with patients complaining of “being whacked into” by people walking past.
Amanda Williams, CQC deputy director of hospitals for Kent, warned that “corridor care must not become normalised”.
“Where a hospital does use a corridor or other temporary space, they must do everything possible to mitigate risk, keep people safe and ensure that their privacy and dignity is protected,” she added.
Despite the systemic failures, the CQC upgraded the department’s ratings for being ‘caring’, ‘effective’, and ‘well-led’ to ‘good’.
Inspectors noted a culture of kindness and respect among the medical teams, praising frontline staff who were “visibly stretched and trying their best to provide good care” under sustained pressure.
The hospital was commended for its dedicated children’s A&E and its collaborative work to deliver a safe environment for people detained under the Mental Health Act.
However, due to a lack of specialist beds, mental health patients faced extended stays in the emergency department, with one patient stuck in the area for four days at the time of the inspection.
Staff also reported an improved departmental culture, feeling well-supported by leaders and confident to speak up.
Dr Des Holden, acting chief executive for EKHUFT, admitted the findings were an “accurate reflection” of the overcrowding.
“This is something everyone in the trust has recognised as unacceptable because we know it has a significant impact on patients’ care, safety, privacy and dignity,” he said.
“This year, we have been working as a whole-hospital team, alongside NHS England and with our partner organisations, to end corridor care in our hospitals.
“Thanks to the hard work of many staff, we now rarely care for a patient in a corridor and we are now focusing our work on eliminating all waits for patients outside a cubicle or bed space anywhere in the hospital.
“I want to thank staff in urgent and emergency care for the incredible effort they are putting in to transform the service – and our whole-hospital team and partners too.”
The trust must now provide the CQC with an action plan outlining how it will address the issues and improve outcomes for people using the service.
