Doctors at a Welsh health board described being “scared to come to work” due to serious concerns over patient safety, according to a report by the Royal College of Physicians (RCP).
The report, seen by the Guardian, highlighted an “unsafe culture” at the Aneurin Bevan University Health Board, with problems including non-specialist doctors routinely being left to handle the emergency care of children, despite not having appropriate training.
Doctors said they had repeatedly escalated concerns to the Aneurin Bevan University Health Board management, but “felt ignored”, the RCP heard during a virtual visit to staff at hospitals in the board’s area in August.
Andrew Goddard, the RCP president, said: “During our virtual visit some trainees told us that they were scared to come to work, in case they lose their GMC [General Medical Council] number. In my eight years at the Royal College of Physicians I’ve visited hundreds of different hospitals – and I had never heard that before.”
The report said doctors had described “very frightening experiences” of treating patients who they were not fully equipped to help and that the visit had been “difficult”.
The board said it took the findings very seriously and was working on solutions to the issues raised in the report.
The visit focused on Grange university hospital, a £358m hospital that opened in 2020 with 470 inpatient beds for patients who need highly specialised services. It also included staff from three district general hospitals, which rely on ambulance services to transfer patients to Grange for specialist services.
The RCP heard that understaffed rotas at the original three sites were now being stretched across four sites, meaning that doctors with no specialist training were left to handle paediatrics, trauma, obstetric and stroke patients – sometimes in minor injuries units. Some doctors reported being expected to work two to three hours extra unpaid every day with many “close to total burnout”.
One trainee doctor, describing a single night shift, said: “I treated a four-year-old with seizures. The ambulance took six hours. Colleagues treated an 18-month-old with burns. Lots of kids come in with respiratory distress. Paediatric cases are not uncommon. We’ve treated stabbing victims. Colleagues delivered a baby earlier in the minor injuries unit. These things shouldn’t happen at all.”
A consultant physician said: “Walk-in paediatric emergencies are still being treated by a non-paediatric team, which is a cause for significant concern.”
Doctors said they had raised concerns with management on multiple occasions. One consultant told the college: “Around 60 doctors wrote a letter to the chief executive, but they just weren’t listening.”
A health board representative told the RCP: “I do recognise that some of the registrars have been very damaged by this experience, and I hugely regret that.”
Responding to the report’s findings, Dr James Calvert, medical director at Aneurin Bevan University Health Board, said: “It is important to remember that the Royal College of Physicians’ visit and report was made during the Covid-19 pandemic, which has significantly disrupted the delivery of our health services. We were already aware of all the concerns outlined in the report and we were working on solutions to the issues raised and we are continuing to do so.
“We are continuing to address staff shortages, which affect our health board as well as other NHS organisations across Wales and the UK.
“The health board has taken the findings of the Royal College of Physicians report very seriously.”