Medway’s A&E is still in a “state of crisis” according to health inspectors - with the department being poorly managed rather than overrun with patients.

The Care Quality Commission carried out an unannounced inspection at Medway Maritime after it received reports of concern from two separate sources.

Inspectors found patients still being stacked in A&E awaiting treatment, with nurses failing to carry out regular observations.

The team had significant concerns surrounding the “apparent inability of the department to cope with even a routine number of patients attending, let alone when surges of activity occur.”

Patients were waiting too long to be seen but the CQC said this was not due to the department struggling to cope with the volume of casualties as inspectors saw empty cubicles.

The watchdog put the delays down to poor organisation of staff and the sick not being prioritised properly.

Inspectors had particular concerns about children waiting too long to be initially assessed.

Following the inspection on July 27 and 28, details of which were only published this week, the CQC told the hospital trust it must take urgent action.

As a result, Medway shut its A&E department for 12 hours to make changes to the way it assessed patients on arrival and ensure all admissions were given an initial assessment within 15 minutes.

Following the closure, hospital bosses said the 15-minute target was being met. But there is more bad news on the way for the troubled trust, which was placed in special measures in July 2013.

The CQC said it has since carried out a further unannounced inspection and have taken further action. The report from that inspection will be published in the next few weeks.

Prof Mike Richards, the CQC’s chief inspector of hospitals, said: “When we inspected A&E at Medway Maritime Hospital in July we found that the department was still falling a long way short of the standards we expect.

"That is why we returned to the department again at the end of August, where we found standards were still not being met.

“We are urgently working with Monitor and NHS England to protect and promote the safety and welfare of people using the department.”

Acting chief executive Dr Phillip Barnes admitted there is still much more work to do.

He said: “We fully accept that improvements need to be achieved in the emergency department and in surgery services and recognise that some changes have not been made at pace.

“That is not to say action has not been taken. We have closed the Vanguard Unit, part of the previous emergency care triage process, and reconfigured the way patients are assessed when they arrive at the emergency department; ensuring they are placed on the correct treatment pathway for their needs as quickly as possible – giving them the care and treatment they need safely and promptly.”

“We are urgently working with Monitor and NHS England to protect and promote the safety and welfare of people using the department” - Prof Mike Richards

The hospital is also being supported by Homerton University Hospital, known for its outstanding emergency department.

An emergency consultant lead and experienced matron are spending two days a week in the department to offer supporting and advice.

Dr Barnes said: “Their insight and expertise brings additional support on our improvement journey in emergency care.”

He added: “There is no denying there is much more work to do and we will continue to work hard on our plans, with our regulators and healthcare partners, to ensure we continue to make progress and fully comply with the Care Quality Commission’s standards.”

The publication of the latest report comes a days after heath secretary Jeremy Hunt criticised previous weak leadership at the hospital and said there were still severe problems.

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