AN inspection report into the Royal Victoria Hospital in West Belfast has found its Emergency Department (ED) is "operating beyond its core purpose and capacity".

The Regulation and Quality Improvement Authority (RQIA) carried out an unannounced inspection at the Falls Road hospital last winter. 

The inspection was carried out in response to the increasing level of concerns the RQIA received about the impact of significant pressure in the ED, focused on a number of areas. These included patient flow, staffing, environmental factors, ED leadership, management and governance.

RQIA inspectors witnessed first hand the operation of the ED, including at night and at weekends and spoke with patients and staff.

The report noted concerns around staffing, crowding, infection prevention control/environmental issues, patient care, medicines, management and governance which they believe had an impact on providing safe and effective patient care. It found the department was operating beyond its core purpose and capacity.

Inspectors found the service did not comply with the quality standards set out by Department of Health for health and social care services.

Briege Donaghy, Chief Executive of the RQIA, said: "During this inspection, RQIA found a dedicated workforce, who were struggling to deliver care above the ED's capacity and outside of the core purpose of an emergency department.

"We have heard the powerful testaments of patients and their families who have accessed ED services and while commending the staff for their compassion and care, have at times been concerned and anxious.

"Clinical Staff and their professional bodies have told us of their severe concerns, frustrations, and distress at the persistence of the situation.

"This RQIA inspection report concurs with these experiences. It describes a service under stress and the inspection findings provide specific evidence of quality and safety at risk.

"The inspection report sets out a Quality Improvement Plan (QIP) that the Belfast Trust has agreed to implement. This will help alleviate some of the immediate safety issues identified, but we must caution that these steps will not resolve the underlying problems.

"Without service reform, the ED will continue to be pressed to operate beyond its capacity and outside its core purpose with resulting increased risks to patient safety and to its staff.

"RQIA recognise that many of the pressures observed during the inspection are occurring at Emergency Departments across Northern Ireland. We have shared our findings with the Department of Health (DoH).

"We will liaise with the Healthcare Policy Group to inform the Service Transformation Programme. We will also liaise with the Strategic Planning and Performance Group (SPPG) of the DoH (Department of Health), to inform a regional response to the findings of this inspection report. This report comes ahead of a predictable increase in demand this coming winter.”

People Before Profit MLA Gerry Carroll has expressed solidarity with staff at the Royal Victoria Hospital following a damning report into conditions at its ED.

The West Belfast MLA said the RQIA report, which flagged overcrowding and staff burnout during the winter period, shows the human cost of austerity. 

“I send full solidarity to the workers in the Royal Victoria Hospital who are at the coalface of the crisis in our NHS,” he said. 

“This A&E and others like it are being kept afloat by efforts of staff who are overworked and completely burnt out. The underfunding and privatisation of our NHS is having a devastating human cost.

“Short staffing, fuelled by poverty pay and insurmountable workloads, is putting lives at risk. A lack of domiciliary care provision, which is largely in private hands, is clogging up emergency departments because patients can’t be discharged in time. 

“Further strike action in the health service is not only likely, but it is absolutely crucial. Revelations by the RQIA should steel health workers and people across our community to fight for the future of the NHS.”

The Royal College of Nursing (RCN) said the report must lead to real improvement.

The Belfast Trust said it had taken steps to address some of the concerns raised by the RQIA ahead of the report's publication and further measures will be undertaken to address additional issues.

West Belfast MLA Gerry Kelly expressed his support to staff following the publication of the report.

“This A&E and others like it are being kept afloat by efforts of staff who are overworked and completely burnt out. The underfunding and privatisation of our NHS is having a devastating human cost,” he said.