WIREDGOV

Unannounced spot checks to test standards of care in district general hospitals across Wales have found “no systemic issues of concern” a report published yesterday revealed.

The independent team carrying out the checks on wards found numerous examples of good and notable practice which far outweighed a few, isolated examples where shortcomings in patient care were identified.

The spot checks will now be extended to look at the standard of care elderly patients receive on mental health wards in hospital settings. Health and Social Services Minister Mark Drakeford ordered the spot checks to be carried out as part of the Welsh Government’s response to an independent review of care at the Princess of Wales and Neath Port Talbot hospitals, by Professor June Andrews and Mark Butler.

The Trusted to Care report, which was published in May, highlighted a number of serious concerns about the quality of care and patient safety in some areas of some wards at the two hospitals, run by Abertawe Bro Morgannwg University Health Board.   Following its publication, Professor Drakeford ordered a series of immediate actions to ensure specific concerns identified in the care of older patients at Princess of Wales and Neath Port Talbot hospitals were not present in other hospitals across Wales.

The spot checks of adult inpatient wards at district general hospitals in Wales were carried out by an independent team of senior individuals, overseen by leading Scottish academic Prof Andrews, former NHS England strategic health authority chief executive Sir Ian Carruthers and Professor Phil Routledge, chair of the All Wales Medicines Strategy Group.

They took place between June 15 and July 30 and focused on four areas highlighted in the Trusted to Care report: medicines management; hydration; the use of night-time sedation and continence care. They were undertaken at all 20 district general hospitals in 70 adult inpatient wards, between 6am and midnight, on weekdays and at weekends.  

The results of the spot checks reveal:

• Overall there are no systemic issues of concern about patient hydration, continence needs or the use of sedation;
• There were individual areas where improvements were needed but the review team also observed many examples of notable practice;
• The review team found medicines management on wards throughout NHS Wales needed to be improved. The main issues they found related to the safe and secure storage of medicines.

The spot check report said:

“While we are confident that progress has already been made, it should not be forgotten that these four areas of concern were selected from a wider range of recommendations in Trusted to Care, which will still require attention. For example, further scrutiny will be needed into the general use of antipsychotic medication for sedation of older patients with dementia.

“The good practice highlighted through the spot checks should be noted by the NHS in Wales and learning shared with other providers of healthcare to support improvement in every setting.

“We look forward to the changes being implemented in the care of older people and we expect all healthcare organisations in Wales to embrace the opportunities for learning that this process has provided.”

Professor Drakeford said:

“After the Trusted to Care report was published, I took action to provide the public and patients with confidence that the care provided to older people in our hospitals is safe and compassionate. I am pleased to say these spot checks have shown this is overwhelmingly the case.

“The spot check teams found there were no widespread issues of concern about patient hydration, continence needs or the use of sedation and they praise the good examples of care they witnessed. However, there were some individual areas were improvements are needed, specifically around medicines management.

“We are already addressing this with the creation of a working group to look at the way medicines are administered, recorded and stored. In other areas, initiatives such as the ‘Drink a Drop’ scheme at Prince Charles Hospital, in Merthyr Tydfil and the iWantGreatCare pilots in Wrexham Maelor and Princess of Wales hospitals show we’re always looking for other ways to get patient feedback and make changes where we need to.

“We will use the findings from the spot checks to help us continue to improve the care of older people in Wales and the lessons we have learned will be shared across the Welsh NHS.”

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