N&N boss confirms warning notice after emergency department inspection

The Norfolk and Norwich University Hospital

The CQC has highlighted its feedback around the hospital's emergency department following an inspection in December. Picture: Nick Butcher - Credit: Archant

The head of Norfolk's largest hospital said work has begun to respond to health inspector concerns around waiting times in its emergency department following its most recent inspection. 

The Care Quality Commission (CQC) visited the emergency department of the Norfolk and Norwich University Hospital on December 8 last year and said that initial assessment and time to treat times of patients were not in line with guidance and "there was no evidence of triage prioritisation".

At a meeting of the hospital's board of directors on Wednesday,  Sam Higginson, chief executive, said the CQC will serve a section 29A warning notice in relation to its four-hour performance and the trust has already begun work on an improvement plan.

A Section 29A notice is served by the CQC when it has concerns at a service.

Mr Higginson told the board: "They noted some improvements particularly around our culture and teamwork which is really pleasing to see. 

"When we get the final report from the CQC we will have a more substantive discussion about their findings in the initial letter, they highlighted some concerns about our four-hour performance, some concerns about triage which we are working through with them and some concerns regarding staffing."

A full report will be published in due course but in its feedback, inspectors noted staff not always washing their hands between patients and the main waiting area not clearly highlighting the need for people to social distance.

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The one-day inspection also found there were delays in admitting patients due to a lack of beds not becoming available earlier in the day.

The CQC praised the hospital's streaming process at the front door, long term improvements in its handover times and positive morale within department staff.

Chief operating officer Chris Cobb said on Wednesday: "It should not be underestimated how challenging that is when your workforce position is stretched and you have additional cleaning, addition infection prevention and control, total segregation and all the hospital is full of emergency patients."

The letter highlighted concerns in the number of nursing staff, but Prof Nancy Fontaine, chief nurse, told the board this was due to Covid sickness and the hospital will be presenting its recruitment and rotas to the CQC to demonstrate the nursing staff levels.