Safety at hospital A&E 'inadequate', says watchdog

Safety concerns about corridor care and delays in patient assessment at East Surrey Hospital have led to a formal warning from a regulator.

The Care Quality Commission (CQC) rated its emergency department and medical care as "requires improvement", with A&E safety "inadequate", after a March inspection.

Inspectors found ambulance patients were "seen in order of arrival rather than prioritised" and there was "limited clinical oversight" of patients waiting for initial assessment.

Hospital bosses accepted the findings of the report and said they had "taken immediate and comprehensive action to address the concerns identified".

Emergency and urgent care at the hospital, in Redhill, was rated "good" after its previous CQC inspection in 2018, although the hospital as a whole has been rated "requires improvement" since 2025.

But inspectors found a service "under sustained and significant operational pressure" in March.

According to the CQC, patients were "routinely" cared for in corridors and waiting areas for "prolonged periods".

Inspectors said patients arriving by ambulance were often "registered in corridor areas without timely clinical assessment", meaning those with life-threatening conditions "did not have immediate access to appropriate facilities".

Resuscitation areas "were frequently at or over capacity and were not used for their intended purpose".

Slow flow through the hospital left patients in the emergency department for "many hours or days" after decisions to admit them, according to the 123-page CQC report.

Concerns were also raised about systems for responding to patient risk, staffing levels and the management of medicines.

Patients, particularly those with mental health needs and children, were "exposed to increased risks", inspectors said.

They wrote that staff "remained committed to delivering good care despite the significant pressures" and patients "consistently spoke positively" about their professionalism.

Medical care elsewhere in the acute hospital also "requires improvement", according to the CQC.

Inspectors said they heard about "ongoing difficulties" getting hospital infrastructure repaired or replaced.

Staff on one ward had said temperatures in their office "regularly exceeded" 30C in summer months as air conditioning was "not functioning", despite "repeatedly escalated concerns".

While one worker had said fire exits were magnetically locked unless an alarm was triggered, inspectors reported they could open multiple doors without activating the alarm.

Workers also reported feeling "shut down" when they raised concerns about staffing levels.

The CQC also found critical care escalation beds had been "placed between bed spaces on many wards", which was impractical for staff. Inspectors said patients reported feeling "claustrophobic".

"In the event of an emergency, the limited space could prevent timely access, putting people at risk of delayed or untimely care," according to the report.

The regulator issued multiple warning notices to Surrey and Sussex Healthcare NHS Trust, which runs East Surrey Hospital, after finding regulation breaches.

"We've told leaders where we expect to see rapid improvements and will continue to monitor the trust closely to ensure people are kept safe in the meantime," said CQC executive Amanda Williams.

The trust said it had "accelerated" its emergency care improvement programme and made changes including investing in frontline staffing, improving initial clinical assessment processes and increasing leadership oversight of safety.

Trust chief executive Andrew Hines said there was "much more we want to do to continue to transform our services" but there had been "significant improvements" since March.

"I am incredibly proud of our staff, who continue to provide compassionate, high-quality care in the face of rising demand and increasing complexity," he said.

"These challenges are common to many other NHS providers, and we will continue to implement national best practice models and work with our partners to improve urgent care pathways for local communities."

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