A NURSE has spoken out about the "chaotic" conditions at Hereford County Hospital saying it is worse than the scandal-hit Stafford Hospital.

Darrell Meekcom, 48, worked as an agency nurse at Hereford from February until just after the damning Care Quality Commission report put the NHS Wye Valley Trust in special measures in October.

He described the hospital as "chaotic" and "dangerous" and said he was considering moving his family away to avoid being treated there.

As reported by the Hereford Times, the CQC report points out major failings in the A&E department saying patients are forced to wait longer than the national target of four hours.

Mr Meekcom, from Hereford, said he believes the hospital needs more experienced senior staff and more space to work in.

He said: "It is the most dangerous. I was at Russells Hall Hospital in the noughties when that was dangerous. I have done shifts at Stafford when that was dangerous.

"But I have never been as worried about a hospital as I am now about Hereford."

His main concern centres around the ambulance triage, as he said nurses work there without emergency care training.

Mr Meekcom said: "It is a very high pressured environment. You need to know what you are looking at.

"You need to be able to assess the patients quickly."

He claimed he would have to rush out to queuing ambulances to see which patient needed to be treated first.

He said one patient who came in with sepsis should have been treated within that first "golden hour".

But Mr Meekcom said it was five hours later when he came back to check on him that he found the patient was still waiting in the corridor. A similar incident with a wait of three and a half hours is highlighted in the report.

He said: "He was climbing the walls. He was in a right state. I quickly ran and got a consultant, who said: 'Why didn't anyone bring him to my attention?'"

On another occasion he said a motorcyclist came in, who had hit a kerb at 50mph, and could have potential internal bleeding.

Mr Meekcom said: "They wanted her to sit in the waiting room. I had a standing argument with the leading nurse that was on and the paramedics.

"I wouldn't let them do it and I wouldn't let the patient go anywhere without seeing a doctor."

He told the leading nurse afterwards that her procedures had been appalling, and he said he was then banned from working on the emergency ward.

He said on his last shift on another ward a patient spoke to him in a derogatory manner. When Mr Meekcom raised the issue with senior staff he said he was told not to work at the hospital again, but he stressed he still has agency work at other hospitals in the area including Shrewsbury and Telford.

Richard Beeken, chief executive at Wye Valley NHS Trust, said: “The trust took the decision that Mr Meekcom’s services, as an agency worker for the trust, were no longer required. This decision did not relate to the concerns he raised whilst working at the trust.”

He said staff are encouraged to raise concerns through the appropriate channels and there is a whistleblowing policy in place, and they worked closely with Mr Meekcom to investigate his concerns.

Mr Beeken added: “It is well documented that our A&E department, in line with hospitals across the country, continues to experience significant demand placed on its services. However, a number of actions and improvements have been put in place during and since Mr Meekcom has worked in the department.

“These improvements form part of the trust’s action plan in response to the CQC inspection, and include £1 million investment in A&E, seven new nurses and a third consultant recruited to A&E.

“The trust is working with the CQC to implement the full action plan as a measured approach to ensure these improvements are embedded across the organisation for the long-term benefit of patients. This may mean that staff and patients will not see immediate further improvements, but I can assure you these changes are underway in a planned way”.

The following incidents at Hereford County Hospital were flagged up in the Care Quality Commission report;

  • Children would wait for long periods during the night. We saw the receptionist prompt the doctor to see three children because they had been in A&E for over an hour without being seen. One child with a head injury was seen only after they started to vomit, and another child with a limb injury was still waiting after three and a half hours.
  • One baby had been triaged by a nurse after one hour and had to wait a further 2hours50minutes for a doctor to review the case. The child had ingested a chemical and been in A&E for three hours and 50 minutes before the doctor checked the online poisons information.
  • The trust's quality indicators showed that patients waited for 50 minutes or more when the ambulance crew could not book them into A&E because it was full. The longest single wait recorded was six hours.
  • The environment on A&E was unsafe for the number of patients attending the department.
  • The children's waiting area was very small. Children were observed waiting in a mixed reception during periods when some adult patients were intoxicated, visibly injured, aggressive and threatening self-harm.
  • Mandatory training included annual life support skills, and in the last 12 months 61% of all nursing staff had received basic life support (BLS) training. Also, 20% of staff nurses had received intermediate life support training (ILS), and 14% had taken an advanced life support (ALS) course in the last 12 months. But, less than 30% had completed paediatric life support training, which meant that a significant number of nursing staff had not received any life support training in the last 12 months. We found that this put patients at risk because there were too few suitably skilled staff to provide care if they needed life support.
  • A culture in the department had developed where staff did not want to upset each other. This was because staff at all levels were under great pressure due to staff shortages and poor patient flow through the department. This meant that medical and nursing staff failed to have vital discussions about improving the safety and responsiveness in A&E. Incidents were not always reported. This led to both the trust and clinical staff not being fully aware of all the safety issues in the service that may require their response.