Welsh review into acutely sick patients' care announced

Royal Gwent Hospital Image copyright Geograph/Robin Drayton
Image caption A report by the public services ombudsman Wales criticised weekend care at Royal Gwent Hospital

A review of care for acutely sick patients in Wales will be launched in the New Year, BBC Wales has learned.

It comes after the public service ombudsman for Wales raised concerns over a series of complaints about failings in weekend care at Welsh hospitals.

Nick Bennett said action was "urgently needed" to ensure safe out-of-hours care.

The Welsh Government said a peer review programme would look at the issue.

The announcement came on Thursday, after the publication of a highly critical ombudsman's investigation into the care of a 93-year-old man who died three days after being admitted to Newport's Royal Gwent Hospital in December 2014.

The report found the man - referred to as Mr Y - was not seen by a doctor for more than six hours on a Sunday, the day before his death.

That was despite concerns about his deteriorating health, with guidelines indicating he should have been medically reviewed within 30 minutes.

'Appalling lack of care'

The ombudsman also found nurses failed to escalate concerns about the delay, meaning antibiotics were not given "in a timely manner".

Mr Y, who was admitted with severe constipation, was also treated on an "unsuitable" orthopaedic ward and had an "undignified end of life".

The report said the ombudsman "could not be certain whether earlier intervention might have led to a different outcome".

Mr Bennett also raised concerns about the decision to keep Mr Y in hospital, where there was a greater risk of infection, despite him having "a full care package" at home.

The ombudsman said the case was an example of "an appalling lack of weekend care".

A spokesman for Aneurin Bevan Health Board, which runs the hospital, said: "Our thoughts remain with the family of Mr Y and we are writing to them to unreservedly apologise for the failings identified in the ombudsman for Wales report."

It has accepted the report's findings and recommendations, which include ensuring procedures are in place to monitor patients' blood glucose levels, ensuring staff properly manage swallowing problems and making sure patients are seen by a doctor "within appropriate timescales".

It was also ordered to pay Mr Y's daughter £2,000 for the "distress and uncertainty" she had suffered.

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Media captionNick Bennett says there is a lack of communication

The health board said it was finalising an action plan to meet further recommendations, such as reminding staff of appropriate procedures and addressing training needs.

"We are committed to learning from concerns raised about our services to further improve the care we offer to our patients and we deeply regret the failings in the care of Mr Y," the spokesman said.

However, the ombudsman said he continued to be concerned by the volume of complaints about out-of-hours care.

In March, he called for a "systemic review of out-of-hours hospital care", after publishing a report which highlighted 12 cases over five years he said had shown "inadequate standards of care" given to patients, including at weekends.

At the time, he said these cases were not typical but a pattern suggested they were also not "one-off" incidents.

"When we published that report, we were told that our methodology was flawed - that the problem had somehow gone away," he said. "The issues are still coming to my door."

Mr Bennett said he was "delighted" the Welsh Government had agreed to launch a review.

Announcing the move, a spokesman said: "Numerous discussions have been ongoing with the public service ombudsman for Wales and a way forward has been agreed. This will take the form of a peer review programme which will look specifically at acutely sick patients. This work will be underway in the new year."

A draft document seen by the BBC, which makes the case for the review, said "unrecognised and untreated acute deterioration" had long been recognised as the cause of a "significant amount of avoidable harm and death in hospitals".

However, it said quantification of this had so far been "difficult and problematic".

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