An inspection of Royal Berkshire Hospital in April found the hospital failed to screen some patients for Covid but said the service controlled the risk of infection well overall.

The Care Quality Commission (CQC) carried out a spot check of infection prevention and control procedures at the Royal Berkshire NHS Foundation Trust on April 29 this year and published its findings on July 1.

The CQC found several areas of outstanding practice but also several areas of concern.

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Chief among the concerns was the failure to check patients’ temperatures when they arrived at the accident and emergency (A+E) department and ask Covid-19 questions, with this only being done at triage.

The CQC said this meant patients with Covid could have been interacting with patients who did not have the disease.

The report also found there were 76 incidents of patients catching Covid-19 in the hospital and dying which met the threshold for a patient safety investigation.

Best practice guidance issued by the Royal College of Emergency Medicine state: “All patients should be screened on arrival for the symptoms of COVID-19 (and other infectious diseases which need isolation) and after being given a face mask cohort in an appropriate area.

“There should be a staff member in sufficient PPE able to provide immediate care to a person before their infectious status is known.”

The CQC said since the inspection the trust has made sure all patients at the emergency department are screened on arrival, assessed for COVID-19 risk, and have their temperature checked prior to triage, with this information documented on their electronic patients record.

The positive aspects noted in the inspection report include:

  • A proactive approach to infection prevention and control
  • High quality blood culture standards
  • The trust was one of the first to initiate staff risk assessment
  • The trust offered access to 24 hour, seven-day-a-week counselling and psychological support for all staff affected by the pandemic.

A Royal Berkshire NHS Foundation Trust spokesman said: “We welcome the CQC report which was wide ranging and generally positive with a few specific recommendations for improvements which we are implementing.

“We want to reassure anyone coming into the Royal Berkshire Hospital that we adhere to strict infection prevention and control policies.”

The trust said it regularly updates its protocols to reflect the latest guidance on managing Covid and preventing cross infection.

What is the process now when a patient visits the emergency department?

Patients entering either A+E department or the minor injury unit have a temperature check and are asked a set of Covid-risk questions when they are booked in.

If they answer yes to any of the questions, or have a raised temperature, this is escalated directly to the Triage nurse who streams the patient to a separate isolation area.

Patients waiting at the new A+E lobby area are advised to observe social distancing .

The emergency department also has an on-site Covid point-of-care laboratory located within the department and staffed 24 hours a day.

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This facility offers state-of-the-art Covid testing technology and gives doctors and nurses rapid information regarding patients before they are admitted.

The CQC also found people visiting relatives were sometimes not given PPE until they were inside wards and hand gels and masks were not in the direct line of sight of people arriving at A&E and were on tables or walls without any signage pointing them out.

Improvements have now been made to improve signage for the masks and hand gel which are provided in the main entrance lobby at the emergency department.