THOUSANDS of patients are piling in to Hereford's overstretched accident and emergency department every month, and the numbers have soared in recent years.

A surprise Care Quality Commission inspection has found a raft of problems in the department, which received an overall rating of 'requires improvement' in a report published this week.

The hospital was also told that safety in the department was 'inadequate', a downgrade from the previous safety rating of 'requires improvement' in 2020.

The most recent report, compiled after the CQC paid a string of visits to the department in December, made frequent reference to overcrowding and “difficult” conditions in accident and emergency caused by the limited size of the department and large number of patients.

READ MORE: Hereford A&E requires improvement after CQC inspection

A&E attendances 2023-2024

A&E attendances 2020-2021

Figures from the NHS show that an average of 5,674 people attended accident and emergency in Hereford each month over six months from the start of August 2023 to the end of January 2024, while an average of 4,802 patients attended each month over the same period in 2020 to 2021, almost 900 fewer per month.

Attendances over four hours 2023-2024

Attendances over four hours 2020-2021

Waits have also gone up significantly, with the number of attendances taking over four hours more than doubling over the intervening period from an average of 1,191 per month over the period in 2020 to 2021, to 2,600 per month over the same period in 2023 to 2024.

Admission waits 2023-2024

Admission waits 2020-2021

And while an average of 206 patients waited four to 12 hours from decision to admit to admission over the period in 2020 to 2021, that had risen to 279 in 2023 to 2024, while the average number of patients waiting 12 or more hours soared from just five to 230 over the years.

Wye Valley NHS Trust, which is responsible for Hereford County Hospital, said inspectors had noted that the layout and “significant limitations with space” meant that it was difficult to hold confidential conversations with patients, and despite staff members’ best efforts, patients’ privacy and dignity were sometimes compromised.

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Among a number of other issues, the report also says that crowding in the department resulted in patients being cared for in inappropriate areas and a poor environment which made it difficult for staff to keep an eye on patients in the waiting room.

But despite the issues found, staff were reported to be kind, considerate, compassionate, and respectful towards patients.

Jane Ives, Wye Valley NHS Trust’s managing director, said the inspectors had highlighted a number of issues the trust was aware of and had been already addressing.

READ MORE: Hereford hospital speaks out after CQC inspection report

“Their return visit confirmed progress in a number of areas with improved governance, improved child-specific training for staff, improvements to the children’s area, and an increase in the number of clinical staff, which included the introduction of a nurse and healthcare assistant to monitor patients in the waiting room 24 hours a day.”

Ms Ives added that the limited size of the department and the increasing number of patients attending were causing congestion in the department. This was being more widely impacted by patients in the trust’s acute and community beds who are medically fit for discharge, but can’t be sent home for a variety of reasons.

The congestion on the wards delays the transfer of patients out of accident and emergency onto wards, which compounds the problem, Ms Ives said.