SERIOUS concerns have been raised about the performance of out-of-hours health services in Wrexham.

Problems with recruitment, staff morale and facilities have led to a widespread overhaul of the running of out-of-hours services (OOH) at hospitals in the region.

Particular concerns were raised about the situation at Wrexham Maelor Hospital, which was rated ‘poor’ by a Betsi Cadwaladr University Health Board (BCUHB) report.

Nigel Lee, BCUHB secondary care director, said a review of the service was commissioned in December 2014 after a number of concerns were raised, and following the review a number of changes had been made straight away.

In the report to be discussed next week, Mr Lee said: “The main area of concern was the increasing difficulty in recruiting general practitioners into the service, resulting in constraints in filling shift patterns.

“Immediate action was taken to strengthen line management and nurse leadership.

“Specific issues such as the incomplete staff suspension processes have also been resolved.”

A number of serious issues were highlighted in the review about the situation at Wrexham Maelor Hospital.

It said: “There have been unfilled clinical shifts in all the OOH sites, particularly in the Wrexham OOH centre.

“This has impacted on response times and staff morale.

“The premises of the three major OOH centres were variable in quality, with Glan Clwyd being excellent, Bangor good and Wrexham generally poor.

“The Wrexham site will require significant development if the aspiration for integrated services is to be delivered.”

According to the review, there were no staff rest facilities, triage nurse conversations were not confidential and could be overheard and there were no easily accessible toilet facilities.

The overall impression was that the whole facility was ‘tired’ and had inadequate work space, the review concluded.

Mr Lee said some changes would need to take time to be completed.

Several other conclusions were made about the service overall, such as the need for better clinical leadership, problems with the management structure, and improvement of performance management.

They also found that an urgent improvement in financial control and in complaints handling was needed.