People 'at risk of harm' as Cornwall's NHS under 'extreme pressure', watchdog warns

Patients needing urgent and emergency medical care in Cornwall are "at risk of harm", according to the healthcare watchdog.

The Care Quality Commission (CQC) says significant work is needed due to what it described as extreme pressure on NHS services in Cornwall and the Isles of Scilly.

The watchdog inspected dozens of sites in April and says staff were exhausted, causing high sickness levels and a rise in resignations.

Inspectors also found ambulance delays and so-called bed blocking were putting further pressure on the healthcare system, with patients often left waiting for long periods of time outside emergency departments.

It a report released today (27 May), the CQC said services are individually well-run but there was a lack of communication between them. It said this means patients face "lengthy delays" as they wait for assessment and treatment.

Andrew lives in West Cornwall. In October his elderly father suffered a stroke and fell downstairs. It took nearly 5 hours for an ambulance to arrive and for him to be treated. Since then he has been in and out of hospital and has recently contracted Sepsis.

Andrew says he doesn't blame any organisation or individual involved with his care but he says the "system is broken".

"The system is broken. You can't blame the people in any of these organisations that are trying to run things smoothly. But there's a massive shortfall in funding and staff. And this affects everybody, all of us.

"If you have an accident these days, you're going to struggle to get taken to hospital in the time that's needed to keep you healthy and safe. And I can't see any end to this."No individual's fault. Everybody in the NHS is doing the job and under extreme pressure it's the system's fault. 30 years of underfunding. 30 years of seeing this coming, forecasting it and not doing anything about it. It's time people stood up and said, We need something done right now. And it can be fixed. It can be fixed right now. 

"15 billion bailing out the energy companies That money can build a new hospital. Why haven't we got a new hospital which has been started to be built in Cornwall years ago? Why not? And it's not too late. We can do that now. It just needs people to make the right decisions. And that's not been made."

What did health inspectors find when they visited NHS services in Cornwall?

Inspectors visited 24 individual services including urgent and emergency care at Royal Cornwall Hospital, some GP surgeries, urgent care services, adult social care services and the NHS 111 service.

The CQC found significant delays across GP care, urgent care, 999 and hospital services in Cornwall and the Isles of Scilly.

The CQC is now calling for all the healthcare organisations across the county to work closer together to ensure the right emergency care is delivered "in the right place, at the right time".

They also found a lack of care provision were causing issues for hospitals as they were unable to discharge medically fit patients. This, they said, meant staff were stretched and there were a lack of beds available.

A care hotel has been set up in Cornwall, providing short-term care for people with a low level of need. The report says it is working well but caring for a relatively small number of people.

The CQC found ambulance staff were not always allowed to refer patients to alternative services, which often resulted in patients waiting outside the Royal Cornwall Hospital's emergency department.

GPs told inspectors significant ambulance delays resulted in them having to provide emergency treatment or extended care. They also reported a shortage of district nurses in Cornwall and a lack of availability in mental health services.

The report adds the closure of Launceston Minor Injuries Unit carried a potential risk of increased waiting times in other minor injury units and emergency departments to access treatment.

NHS care in Cornwall 'poor' as staff 'exhausted'

The CQC's director of integrated care, inequalities and improvement, Amanda Williams, said performance across all sectors "remained poor".

She said: "It was clear the majority of the services we inspected were trying to provide good care. However, there was lack of cross organisational working which meant the system was under extreme pressure and struggling to meet people's needs in a safe and timely way."

She said staff are exhausted and there are now high levels of sickness and resignation.

"Staff shortages in social care across Cornwall, especially for nursing staff, are some of the highest seen in England," Williams said.

She added without significant improvements in patient flow and better collaborative working it is "unlikely that patient safety and performance across urgent and emergency care will improve".

In response chief executive officer for NHS Cornwall and the Isles of Scilly Integrated Care Board Kate Shields said the report makes difficult reading.

"It's really difficult for our people working in health and care trying to provide services in the environment at the moment," she said.

"It's really hard for people in Cornwall to face significant delays and access to existing care. So we are working really hard to try and address the concerns that are raised.

"We don't take it lightly, we take it really seriously and we want to get it sorted as quickly as possible."