Patients at Bronglais Hospital’s A&E department are “often cared for in corridors”, a report has found, as inspectors praise its dedicated staff but raise concerns over patient safety and quality of care.

Healthcare Inspectorate Wales (HIW) published its inspection report on 18 December following an unannounced visit to the Emergency Department at Bronglais Hospital in Aberystwyth carried out over three days in July.

Inspectors praised the “dedication and professionalism of staff working under considerable pressure”, noting that patients were “consistently treated with dignity and respect.

Inspectors identified several areas requiring improvement to protect patient safety and maintain the quality of care being delivered.

These included concerns around medication management and storage, incomplete checks of emergency resuscitation equipment.

Patient flow challenges were a recurring theme, with delays in triage, overcrowding, and inadequate paediatric provision “contributing to operational pressures.”

“Patients were often cared for in non-clinical areas such as corridors, due to delays in discharging patients from other parts of the hospital, impacting privacy and dignity,” the report said.

“HIW has recommended that the health board continues efforts to improve patient flow and reduce reliance on non-clinical spaces.

“Although trained staff provided good oversight of the waiting area, reception staff had not received ‘red flag’ training to recognise time-critical conditions, and delays in responses from specialist teams further affected patient care.”

The report added that “despite ongoing challenges with patient flow and patients being treated in non-clinical areas, staff maintained a compassionate approach and demonstrated strong teamwork across the department.”

The inspection also raised concerns about the safety and condition of emergency equipment.

Checks on paediatric and difficult airway trolleys were “not consistently recorded”, inspectors found, while “appropriate safety signage was missing in the oxygen storage area, and temperature records for medication fridges were incomplete.”

Inspectors also found that the paediatric area was not consistently staffed with paediatric-trained nurses and was used to accommodate adult patients.

Hand hygiene compliance was low, and there was “no dedicated provision for cancer patients or those at increased risk of infection.”

Staffing levels within the department were “generally acceptable, with minimal reliance on agency staff,” the report found, but said that “consultant cover was limited, particularly overnight and at weekends.”

HIW has urged the health board to progress recruitment and ensure safe and effective cover arrangements.

“Despite these challenges, the culture within the department was found to be positive and inclusive,” the report found.

“Staff worked well together and were committed to providing high-quality care.”

Alun Jones, Chief Executive of Healthcare Inspectorate Wales, said: “Staff at Bronglais Hospital’s Emergency Department are clearly dedicated to providing safe and compassionate care despite very difficult circumstances.

“Our inspection highlighted areas of good practice but also identified significant issues with patient flow – challenges that are present across many Emergency Departments in Wales.

“We will continue to engage with Hywel Dda University Health Board to ensure improvement and progress against our findings.”

The health board has produced a comprehensive improvement plan with detailed actions on how improvements will be made at the emergency department.