More staff needed at Wrexham Maelor Hospital, report finds

The RCP published a follow-up review following its virtual visit to Wrexham Maelor Hospital in May 2021. RCP Cymru Wales has worked closely with Betsi Cadwaladr University Health Board (BCUHB) over the past year as the health board has developed a 12-point action plan to improve patient care and medical education across its hospitals.

READ MORE: Wrexham Maelor Hospital doctors 'unhappiest ever seen', report says

The health board has committed to establishing regular communication with clinicians, evaluating how patients are moved around the hospital, and reviewing how doctors in different departments work with each other to provide patient care. Members of the executive team have met with the RCP vice president for Wales to discuss how they will address the issues highlighted in the RCP report.

In its follow up review, the RCP has now called on BCUHB to communicate more clearly and more frequently with consultants and junior doctors, ensure that staffing numbers are increased before any new clinical sites are opened in North Wales, and address issues around the lack of occupational health support.

BCUHB has also been told to invest in facilities and IT infrastructure at Wrexham Maelor Hospital.

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This review comes as the RCP publishes data from its 2020 national census of higher specialty trainees in Wales which found that:

• Only 43 per cent of senior trainees across Wales felt valued by their health board or hospital      
• Fewer than half (48 per cent) felt in control of their workload
• 30 per cent said they work excessive hours
• 69 per cent of senior trainees in Wales said their own morale was worse since the pandemic started
• 77 per cent said team morale was worse since the beginning of the COVID-19 pandemic.

Trainees must meet certain requirements to progress in their medical education to become a consultant, including attending a certain number of outpatient clinics. Many junior doctors across Wales are struggling with an excessively heavy workload which means they cannot leave hospital wards to take part in teaching opportunities.

However, trainee doctors at Wrexham have pioneered 3-month clinic blocks, which allow protected time for education. The RCP vice president for Wales Dr Olwen Williams called the project an ‘example of excellence’ and has recommended that other health boards consider a similar approach.

Dr Olwen Williams, RCP vice president for Wales said: "BCUHB, like many other health boards is currently under extraordinary pressure due to Covid-19 outbreaks, staff sickness, and delays in getting patients home.

"I am pleased to welcome this action plan from Betsi Cadwaladr UHB. While it is a positive move, it is crucial that the health board leadership listens to staff, takes their concerns on board and addresses these issues through genuine clinical engagement."

He continued: "When the RCP visited Wrexham virtually in May 2021, many senior consultants felt excluded, ignored and frustrated.

"They told us about a perfect storm of an ageing hospital, ineffective IT systems, and chronic staff shortages. By the time we returned to speak with them again in January 2022, they had worked through a fourth wave of Covid-19 combined with the usual winter pressures: they were very tired, but still passionate about improving patient care and teaching the next generation of doctors. I am proud to call them my colleagues. Trainees in particular have taken the initiative and worked with senior consultants to make improvements."

Dr Williams added: "The post-pandemic NHS recovery must be patient centred and clinically led: this means listening to staff, acting upon their concerns, avoiding the blame game, and crucially encouraging them to lead change. In the longer-term, we need to recruit more health and care professionals, open the medical school in north Wales as soon as possible, and place a renewed focus on staff wellbeing, flexible working and career development. The NHS in Wales must prioritise the mental health of its workforce as we begin tackling the backlog.’

Dr Nick Lyons, executive medical director at BCUHB said: "We have taken the RCP report very seriously and have developed an action plan with the physician consultant body at Wrexham Maelor Hospital.

"We’re making real progress in addressing the concerns raised, as acknowledged in the RCP’s follow-up review. This highlights improvements including strengthening medical leadership on site, recruiting a specific medical bed manager and reviewing the management structures for doctors working across unscheduled care.

"We're aware that workload, stress and pressures that our clinicians face have not gone away and are committed to ensuring that colleagues are supported to do their jobs to the best of their ability. We will continue to work with our clinical teams to implement the RCP's recommendations."