Norfolk's largest hospital has been warned to make improvements after inspectors raised concerns around patient waiting times and staff not always washing their hands or wearing protective equipment.
The Care Quality Commission (CQC) has issued an enforcement notice to the Norfolk and Norwich University Hospital following an inspection of the emergency department (ED) in December, rating the service as requires improvement.
The inspection was triggered by performance data showing that national targets for waiting times were not being met, and on the day found 104 four-hour breaches, including one 12-hour breach and walk-in patients not always triaged within 15 minutes of arriving.
Seven patients' triage was delayed by more than an hour, including one who was waiting in "physical discomfort with clear abdominal pain", the report said.
In relation to infection control, the report highlighted staff not always wearing protective equipment when within two metres of patients and in the main waiting area, some chairs had labels advising patients not to use them, but people were sitting within a metre of each other.
Fiona Allinson, CQC head of hospital inspection, said: “The trust must improve the department’s staffing arrangements and triage processes, so that it assesses and treats patients promptly and ensures their safety. It must also ensure that equipment is checked for safety, and that guidelines to prevent the spread of infection are followed."
On the day of inspection, half of patients attending the department were not seen within four hours.
The report said: "Although we did not see any harm as a result of delays in treatment, there were potential risks to patients from spending too long in ED."
The report highlighted staffing shortages but found improvements in the department's culture. There were two areas of outstanding practice including the trust's emergency provision for older people.
The trust remains rated as "requires improvement" overall.
Sam Higginson, NNUH Chief Executive, said immediate action was taken following the inspection and the department has dedicated staff supporting patient triage 24/7, with eight new consultants joining the team in due course.
The trust has also brought in more robust infection controls and protective equipment for department workers and plans to further improve discharge and patient flows.
Mr Higginson added: “Our staff have gone above and beyond during the pandemic and that is reflected in the recognition of outstanding practice in our older people’s emergency department and safety nurses, and we are determined to continue to improve our performance, together, to deliver the best possible care and patient experience.”
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