25 June 2024

Following on from Channel 4’s Dispatches, which highlighted the challenging conditions in our urgent and emergency care services at the Royal Shrewsbury Hospital, we want to apologise to those affected in the programme and to everyone in our communities who has been affected by long waiting times, overcrowding and a lack of privacy when accessing emergency care.

Even when we are faced with significant pressures, we must uphold the highest standards of care and we recognise that some of the conditions displayed in the programme did not meet these standards. Across the wider Trust, we are determined to ensure we consistently deliver the care, compassion and dignity we strive for our patients.

As with other hospitals, our Trust is facing significant challenges with urgent and emergency care. We understand our challenges and are investing in our services and making steady improvements as a Trust, as noted in our recent CQC report. However, there is still much more to do; we do not want to be in a position where we are caring for patients on corridors.

We are very sorry that our patients have experienced anything less than the quality care we strive for, and we are determined, working with partners, to improve the care and experience for everyone. We are continuing to do everything possible to support the privacy, dignity and wellbeing of our patients, and have adapted the way we deliver care in our urgent and emergency care services by investing in additional staffing, screens, cleaning and catering. We recognise there is still further to go on our improvement journey.

Our colleagues are working incredibly hard to maintain safe services and we are grateful for everything they are doing to support our patients in this difficult working environment. We would also like to thank our patients for their support and understanding during this time.

Our Emergency Departments are open and we want to reassure our communities that your safety is our top priority and we are here to help you, if you need urgent and emergency care. Local communities can also support us by choosing the right service for their needs, including using pharmacies, minor injury units or 111 for advice and signposting and 999 in an emergency – your support really helps us to reduce waiting times for those who most urgently need our care.

Families, and carers can also support our clinical teams by having early conversations about any support you may need so we can help ensure your relative is discharged when they are clinically ready to leave hospital.

We will fully explore all the feedback and incorporate the learning into our improvement work. We are committed to working with and listening to feedback from our patients, communities, partners and colleagues as we seek to improve urgent and emergency care for everyone.

If you are worried about anything you have seen in the programme, or have questions or concerns about the treatment you, or a family member, have received please contact our Patient Advice and Liaison Service who will do their best to support you. People can also contact their local Healthwatch or Llais who are independent organisations that champion the voice of people using health and care services locally.

Further information

We understand our challenges and are investing in our services. We are making steady improvements but recognise there is much more we need to do. Below are some of the ways we are working to improve care and support a positive experience for our patients.

  • In April and May 2024 our A&E departments supported more than 26,700 patients. We are continuing to see a rise in our urgent and emergency care attendances every year, with 13% more overall A&E attendances when compared to levels seen in 2019/20 (based on January 2020 and January 2024 data to recognise the impact of the COVID-19 pandemic). This compares to a 5% increase nationally.
  • We are recruiting more housekeepers, as they play an invaluable role in our Trust supporting the cleanliness of our departments.
  • We have invested in additional staffing, especially in our nursing teams, to maintain safe staffing levels recognising that we have more patients in our departments
  • We are focused on improving the nutrition and hydration needs of our patients, and thanks to our housekeepers and volunteers are offering patients waiting long times food during mealtimes.
  • We will be working with our colleagues to continue to promote good infection, prevention and control practices.
  • We are doing everything possible to improve the comfort and experience of our waiting areas. We have invested in specialist, padded seats and recliner seats in our Fit to Sit areas, however we recognise that patients are waiting longer than we would want. We will be reviewing our Fit to Sit areas and doing everything possible to reduce waiting times.
  • We have a regular estates programme to ensure that our environments are decorated and kept in working order, for example we recently repainted the Emergency Department at PRH.
  • We have made improvements in our triage times with more patients assessed within 15 minutes.
  • We have strict criteria in place and assess all patients to determine if they are able to be in a hospital chair or to be on a trolley in an escalation area. Only patients with lower acuity (medical) needs will be treated in these areas. We have increased our staffing in these areas and will be ensuring that patients are regularly offered reassurance and their needs are supported.
  • We will have invested in more modern digital systems in our emergency departments that will help us to monitor the patients who are waiting in our departments and ensure that observations are being carried out on time. This will take time to embed, but we are committed to supporting our clinicians to improving care through more modern tools.
  • We have made a Trustwide commitment to improving urgent and emergency care. We are launching a new campaign internally, and with partners, helping everyone to understand their role in improving urgent and emergency care.
  • We are open to learning and feedback and are continuing to work with national experts who are working in our departments, exploring all opportunities to improve flow through, and out of our hospitals.
  • We are working with partners to increase capacity for patients not requiring acute (hospital) care. Following national investment, we have opened 52 beds in new Rehabilitation and Recovery Units at both Princess Royal Hospital (PRH), Telford, and Royal Shrewsbury Hospital (RSH), run by Shropshire Community Health NHS Trust (Shropcom). These units provide general rehabilitation, often for people who are frail and elderly, or require specialist rehabilitation, for example people who have had a stroke or broken hips, who cannot be supported safely in their own homes, but do not need to remain in an acute hospital bed.
  • Investment in community health and social care capacity has reduced patients waiting for discharge in hospital beds by two-thirds. We are also working with Shropcom following investment in 167 Virtual Ward beds and a new Outpatient Parenteral Antibiotic Therapy (OPAT) service which aims to support patients to be discharged from hospital when they are medically ready. However, we recognise that demand for hospital beds continues to be high and there is more work for all partners to do to improve care for everyone.
  • We are continually investing in our services, supporting patients to be seen and assessed by the right clinicians, first time without waiting in our Emergency Departments. This includes supporting direct access for GP emergency admissions. We know we have more to do to improve the efficiency of these services, due to the current demands for hospital beds:
    • Opening the new Acute Assessment Floor at RSH in December 2022
    • Improving the Same Day Emergency Centre at PRH
  • Action taken internally to improve patient ‘flow’ through the hospital to enable earlier/more timely discharge of patients to create bed space for patients needing admission from our EDs and assessment areas.
  • Working closely with health and care system partners to look at additional community and social care capacity to support timely discharge and create bed space to take patients from A&E.