Blocked Fire Exits and Overcrowding Raise Safety Concerns at Royal United Hospital in Bath

A recent inspection at the Royal United Hospital in Bath revealed serious safety concerns, including blocked fire exits and overcrowding that pose risks to patient safety. The Care Quality Commission (CQC) found that trolleys were obstructing fire escapes and the children’s resuscitation room, creating a hazardous environment in the emergency department.

The CQC’s unannounced visit last October highlighted multiple issues: high nursing vacancies, a shortage of senior doctors overnight, and overall staff shortages that compromised patient care. Inspectors identified three regulatory breaches related to safe care and treatment, staffing levels, and service management. As a result, the emergency department received an overall rating of “requires improvement.” The categories of Safe, Responsive, and Well-led also received this rating, while Effective and Caring were rated “Good.”

Catherine Campbell, CQC deputy director of hospitals for the South-West, commented on the pressures faced by the department: “The Royal United Hospital’s urgent and emergency care was under enormous and unsustainable pressure. Despite this, staff remained committed to providing safe care. However, the lack of senior doctors overnight and high nursing vacancy and sickness rates left critical gaps in cover. Agency and bank staff were often brought in but did not always possess the specialist skills necessary to manage complex emergencies, potentially putting patients at risk."

Overcrowding was a significant concern. Trolleys blocked access to vital areas, including fire escapes and the children’s resuscitation room, risking delayed emergency responses. Ms. Campbell noted that hospital leaders acted promptly when these hazards were raised.

The inspection also revealed extended wait times for mental health patients, who endured an average seven-hour wait for a bed in a loud and challenging environment. “No one should have to wait that long under such distressing conditions,” Campbell said.

Despite these challenges, inspectors recognized positive elements. Staff were praised for treating patients with compassion and individuality. The department’s performance in minimizing unplanned reattendances exceeded both regional and national averages, indicating patients were discharged appropriately.

Although the urgent and emergency care’s caring rating was downgraded from “good” to “requires improvement,” the hospital’s overall rating remains “requires improvement,” while the Royal United Hospitals Bath NHS Foundation Trust maintains a “good” rating.

In response, a hospital spokesperson acknowledged the CQC report and outlined the improvements underway: increased senior decision-makers overnight, around-the-clock security, enhanced oversight of emergency access points to prevent obstructions, and collaborative efforts with mental health and ambulance services. The hospital is also working with the national Getting it Right First Time team to update professional standards.

The statement highlighted the hospital’s strengths, including effective handling of sepsis, safeguarding concerns, and compassionate care for patients with autism and learning disabilities. The hospital acknowledged record demand pressures, including a 25% increase in ambulance arrivals and 13% increase in emergency visits, and described ongoing efforts to prevent overcrowding and corridor care in the coming winter.

Looking ahead, the hospital secured capital funding to build a new Urgent Treatment Centre this year and plans to rebuild the Emergency Department over the next three years.

The hospital concluded by commending staff dedication and expressing gratitude for the support of partner organizations in addressing these challenges for the benefit of patients and the community.