Patients Left Without Dignity in Overcrowded A&E Department
Bed-bound patients at Medway Maritime Hospital were reportedly told to “soil themselves” due to a severe lack of staff available to assist them to the restroom, as detailed in a recent report by the Care Quality Commission (CQC). One patient, in a desperate situation, was observed urinating into a bottle in full view of other patients, without any privacy curtains. Alarmingly, some individuals remained in soiled clothing and bedding for extended periods, as long as “hours.”
Inspectors highlighted a particularly troubling case where a patient was forced to endure a staggering 55-hour wait on a chair in a hospital corridor at the facility located in Gillingham, Kent, which is operated by the Medway NHS Foundation Trust. Other accounts from patients revealed waits of two days or more before being assigned a bed. Additionally, some staff members expressed feeling unsafe when raising concerns, while others reported living in fear of repercussions from senior leadership.
‘No Privacy or Dignity, and 55-Hour Corridor Wait’
The CQC report articulates, “Patients, relatives, and staff reached out to us prior to the assessment to share that patients were not always protected from degrading experiences.” It further details instances where frail patients, unable to get to the restroom independently, were left to soil themselves and remained in soiled clothing for hours on end.
- During the inspection, staff witnessed a patient passing urine into a bottle without any privacy provided.
- Patients were found stranded in the emergency department for over 50 hours, lacking access to basic wash facilities.
- Furthermore, there was a severe shortage of pillows and blankets for patients, including those on trolleys near the ambulance entrance, leading to individuals remaining in soiled garments, with medications not administered.
One patient reported feeling “so cold” due to the absence of blankets, while another was found waiting in a chair for an astonishing 55 hours.
‘Staff Crying on the Phone for Help’
Feedback from patients to inspectors included chilling remarks about the conditions: “Corridor care is horrible and provides a disgusting level of service.” Another patient recounted how an elderly lady had to wait in the emergency department corridor due to a lack of beds, emphasizing the absence of privacy and dignity, where screens were hastily pulled around her to use a bedpan, yet there was nowhere for her to wash or change clothing.
Staff described a critical shortage of qualified nursing staff, which caused significant delays in patient care. A patient reached out to the CQC, sharing that “staff were crying on the phone for help, yet no one seemed to respond.” Many patients reported they had been left sitting in their own waste throughout the day due to a lack of available assistance.
Some employees informed inspectors that the emergency department was understaffed and that the number of consultants employed fell short of the Royal College of Emergency Medicine (RCEM) guidelines. In contrast, senior leaders maintained that a staffing review was completed, asserting the department was adequately staffed according to budgetary constraints.
‘Toxic Culture’
Following a CQC inspection in February of the previous year, the urgent and emergency services at the hospital were rated as “requires improvement,” prompting the issuance of a warning notice to the trust, mandating necessary improvements. Between August 31, 2023, and April 4 of the following year, 15 hospital staff members contacted the CQC to voice concerns regarding the department’s culture. Several described the environment as toxic, attributing this to the behaviors and capabilities of leadership.
- Three staff members reported experiences of bullying by leaders.
- Five indicated they were threatened with disciplinary action or targeted for speaking up.
- Nine shared that leaders took no action in response to concerns raised, resulting in no changes.
Workers described interactions with some leaders as “mean,” recalling instances where conversations were abruptly halted with phrases like “conversation closed” and “discussion over,” while others were chastised by being told they were “dropping the ball” and needed to “work harder.” During the on-site assessment, numerous staff members expressed that their concerns regarding staffing shortages and overcrowding were ignored and dismissed by immediate leaders.
What Do Hospital Leaders Say?
The trust managing Medway Maritime Hospital claims to have made “significant improvements” over the past year. Jayne Black, the chief executive of Medway NHS Foundation Trust, stated: “We deeply regret that despite the dedicated efforts of our staff, the inspection team found our care did not meet the expected standards during last February’s evaluation. Over the past year, we have implemented substantial improvements to ensure that patients attending our emergency department receive timely treatment, are cared for in appropriate settings, and receive compassionate care.”
She continued, “We acknowledge that there remains much work to be done, particularly in reducing delays for patients awaiting admission to a ward, ensuring every patient receives the high standard of care we strive to deliver. Our entire hospital staff continue to work tirelessly, in collaboration with our ambulance, community, and social care partners, to minimize delays and enhance care for all patients visiting our emergency department.”
