What did the CQC report say?

Southmead Hosptial's emergency and urgent care service has been rated inadequate for a second time.

The Care Quality Commission issued North Bristol NHS Trust with a warning notice in December last year following concerns over the quality of service provided to patients.

But, after another unannounced inspection in May, the CQC found that although some improvements had been made, not enough was being done to ensure it provided effective and well led services.

Inspectors found overcrowding, insufficient staffing and patients waiting too long for pain relief.

In December the trust was told it must take action to deal with demand in the emergency department, where patients were waiting too long to be assessed and treated.

After the most recent visit inspectors found that there had been improvements in the management of patients within the reception area and minors' area of the emergency department. The trust recruited two additional consultants which allowed rapid assessment and treatment to be carried out during weekdays.

But inspectors found patients arriving by ambulance, who had to wait in corridors, were often left too long to be seen in the overcrowded area.

The hospital had also not increased staffing levels to deal with predictable surges in activity. Those staff who were deployed to support the department were often inexperienced.

Performance against the standard requiring patients to be discharged, admitted or transferred within four hours of arrival remained consistently below the 95 per cent target.

Access to food and drink while patients waited in the department had improved with better availability of water and the recruitment of a housekeeper who undertook regular tea rounds. Inspectors found that staff continued to demonstrate resilience and professionalism while working in challenging conditions.