North Devon District Hospital staff shortages 'put patients at risk'

Northern Devon Healthcare NHS Trust chief executive, Suzanne Tracey, responds to the report.

A hospital in Devon has been told it "requires improvement" as patient safety has been put at risk by staff shortages.

The North Devon District Hospital in Barnstaple was inspected by the Care Quality Commission (CQC) in July 2021 following concerns about its staffing levels.

The CQC found the hospital’s medical care services were limited because there were not enough members of medical or nursing staff available.

But staff were praised for treating patients with compassion and kindness.

The report added that care was not always provided "in a timely manner" and the CQC’s head of hospital inspection, Cath Campbell, believes the situation is concerning.

'This put patients at risk of harm'

She said: "When we inspected the medical care services at North Devon District Hospital, we found a high number of vacancies with a reliance on agency staff, and not addressing issues around the availability and responsiveness of medical staff for deteriorating patients. This put patients at risk of harm.

"Although nursing staff were quick to identify and act when they spotted patients who were at risk of deteriorating, medical staff did not always attend to these patients quickly.

"We saw two patients waiting an hour or more for the doctor to assess them and administer appropriate treatment.

"There were also occasions when doctors did not respond when paged by the nursing staff, forcing them to contact the intensive care unit to request one of their doctors to urgently review a patient who had deteriorated.

"It was also very concerning to hear a few staff were labelled negatively by their managers for reporting too many incidents.

"This was preventing other staff from coming forward to report incidents, especially in relation to being short staffed.

In one incident, a patient with a wounded finger should have been discharged from the emergency department within a couple of days but a lack of staff meant the patient spent more than three weeks in hospital.

'Outstanding' caring rating

Having said that, the report also stated that the hospital retained its 'outstanding' rating for being caring, and the rating for responsiveness also remained as 'good'.

Staff have also been commended for treating patients with compassion and kindness, as well as being well skilled at introducing measures to combat rising anxiety among patients during the pandemic.

Cath added: "The medical care services team is thoroughly deserving of its outstanding rating for being caring, which it retained following this inspection. The service introduced a number of commendable new initiatives to reduce patients' anxiety during the COVID-19 pandemic.

"We have told the trust it must address the medical staffing issues as a priority, and it has assured us it is working hard to do so. As well as recruiting new staff, it has been working with another neighbouring trust to support care provision at the hospital.

"We have also told the trust to ensure the service responds appropriately and quickly when patients are deteriorating, and that staff are encouraged to report all incidents, including near misses.

"We will keep a close eye on progress and will return to ensure the required improvements are made."

'Patient safety is absolutely our priority'

The North Devon District Hospital is run by the Northern Devon Healthcare NHS Trust (NDHT) and its chief executive, Suzanne Tracey, understands that the hospital has been under pressure.

"Clearly it’s disappointing for us to have a rating that indicates ‘requires improvement’ but also I think it’s probably a realistic assessment of the challenges that are faced by NDHT.

"This is something that’s been longstanding and it underlines the reason why the Trust has been working with its neighbour, Royal Devon and Exeter Hospital, to find different ways to meet the clinical sustainability challenge.

"The report, I think, gives a balanced view. The challenge we've got is that we haven't got enough staff in post, particularly medical staff.

"But there has been an unrelenting focus by our staff day in day out to make sure that we can support all of the shifts in the best way that we can and of course patient safety is absolutely our priority."