Monitor calls for Trust to improve A&E waiting times


Monitor, the independent regulator of NHS Foundation Trusts has today announced that it is using its regulatory powers of intervention to require Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) to improve A&E waiting times for the benefit of patients.

 Consistently meeting the A&E 4 hour waiting times is a high priority for the Trust and a detailed action plan has been produced and is already being implemented. More will be added to the plan following a countywide multi-agency review due to take place in May which will include community and social services.

Monitor also announced that it will be joint addressee on an independent review of Board Governance which the Trust Chair, Professor Clair Chilvers had already decided to commission to take place this Autumn. This review will look at the effectiveness of our Board processes.

Following discussions with Monitor it has now been agreed that this review will be brought forward.  The review report will go to both Monitor and the Trust Board, with Monitor holding the Trust to account for delivering any recommended actions.

In its communications today Monitor has clearly stated that the CQC has no outstanding concerns about the outcomes of patient care at the Trust.  

Chair, Professor Clair Chilvers said: “As a Board we acknowledge that this is a very important area and that we have struggled to consistently see, treat and admit or discharge 95% of patients in our A&E departments within four hours. This is a cause of frustration to patients, to our frontline staff and a cause of great regret to the Board.

“We have stepped up our response to this problem with a detailed action plan and are confident and determined that we will be able to solve it for the benefit of patients. I would also like to reassure patients that although there have been delays in A&E, there is no suggestion that patients are receiving poor clinical care.”

Since March 30th our Director of Nursing, Mrs Maggie Arnold, has taken on the role of Project Director for Emergency Care, leading a programme of work to improve the flow of emergency patients throughout our hospitals. This looks at all aspects of a patients ‘journey’ from the time they arrive in A&E, going  through diagnostics and inpatient treatment right through to making improvements to the way we discharge patients from hospital.

“We are in the process of implementing our plan which we will be adding to and we have made this the highest priority for the Trust in the coming year.”

Actions currently being taken include:

  • Building new consultation and treatment cubicles in the A&E Departments at both Gloucestershire Royal and Cheltenham General Hospitals
  • Reviewing the distribution of staff and employing more A&E nursing staff
  • Changes to the discharge process including earlier and more frequent ward rounds – so that beds are available for emergency patients earlier in the day when they are needed
  • Reducing unnecessarily long length of stay in our hospitals for patients who are ready to leave hospital
  • Further development of Surgical Assessment Units to assist with patients who are referred to hospital by their GP and may remove the need for patients to be admitted to hospital
  • Working with colleagues in the NHS community and social care

Since starting work on this intensive programme, Mrs Arnold has reported excellent support and engagement from staff right across both hospitals who want to make a difference and initial results are encouraging.

Mrs Arnold said: “We have some way to go but I am encouraged by the response from staff and I am confident that in the forthcoming period we will begin to consistently deliver the four hour target.”

For the month of April  93.5% of A&E patients were seen, treated and discharged or admitted within 4 hours, against a target of 95%.”

For more information read Monitor's press release.