07:57
Tieng Anh Vui
Some departments at Wales' biggest hospital are "dangerous" with patients "dying regularly" while waiting for heart operations, surgeons claim.
The findings are made in a report on Cardiff's University Hospital of Wales by the Royal College of Surgeons (RCS).
They also warn that children are suffering due to delays in surgery.
Hospital chiefs said they accepted pressures earlier in the year were "unacceptable" and problems were being addressed.
An action plan has been agreed with the health board and will be reviewed by surgeons in the autumn.
'Severe risk'
The report by the RCS followed a visit to surgical departments by its Public Affairs Board for Wales (PAB) in April this year.
Colin Ferguson of the RCS says surgeons can't do their work in a 'timely' fashion
The report said there was "universal consensus" amongst the clinicians that services at the hospital were "dangerous" and of "poor quality".
It said "urgent attention" by Cardiff and Vale University Health Board (CVUHB) was needed to address the issues.
The visit highlighted several examples of what the report called "serious service problems" which represented a "severe risk to patients".
Surgeons said concerns included:
- Cardiac patients "regularly dying on waiting lists" with "other patients' hearts ... deteriorating while waiting" making subsequent treatment more difficult
- Children regularly being fitted with hearing aids because of a lack of surgical time and resources to insert grommets to treat ear infections
- Patients "suffering complications" because of delays in treating kidney stones
- A&E and intensive care units being "frequently grid-locked" with patients "often stacked up in corridors and ambulances"
The single most common complaint from the hospital's surgeons was the inability to admit patients for scheduled, or elective, surgery.
They reported that more than 2,000 operations were either not scheduled due to a lack of beds or cancelled in the first three months of this year.
"I think our colleagues were telling us that they believed there was significant risk as a consequence of their inability to get patients in to have their operations in a timely way," said Colin Ferguson, director of Public Affairs for the RCS in Wales.
'Frustrations'
"The reasons for that are obviously complex and relate to the whole system of care within the hospital. They relate to emergency medicine, they relate to the admissions coming through the A&E department.
"They were very frustrated. As a group they were expressing to us very clearly that they thought the current situation was unsustainable, and something had to be done about it."
The report said doctors also believed the health board was reducing its scheduled surgery in order to reduce costs "to meet end of year financial targets".
An increase rise in waiting lists, according to the report, meant that patients "were clearly coming to harm".
Responding to the report, the chief executive of the health board, Adam Cairns, said he accepted that the situation earlier in the year was cause for concern.
"I'm on record already having apologised to our patients," he told BBC Wales.
"It is not a position that we can take any pride in - we need to do better."
Mr Cairns said the first few months of 2013 were "a time of relentless pressure" on the NHS.
"It is fair to say that this organisation was struggling, like many others, to cope with the pressures," he said.
Child priorities
"The circumstances that we found ourselves in, I think, are unacceptable, and we've got to make sure that in the future that we have a much better response."
Mr Cairns said steps had been taken to protect surgical beds for children's services.
Additional resources for cardiac treatment are also being put in place, including securing extra surgical capacity outside of the local health board.
"Some of the things that we are already doing are showing some improvements," insisted the chief executive.
"The bottom line here is we can, and we will, do better."
However, the RCS has also taken the step of passing its report to the health minister Mark Drakeford, which led to a meeting in June.
"The Health Minister was very concerned to read the Royal College of Surgeons report and the risks to quality and safety it highlighted," said a Welsh government spokesperson.
It led to an action plan being drawn up by the health board, NHS Wales and Welsh Health Specialised Services.
"This plan has now been produced and is being implemented, and the Minister is being kept informed of progress on a regular basis," said the spokesperson.
The RCS said it will now make a return visit to the hospital and health board in September to review the situation.
"At the moment it is too early to tell whether the action plan will address our concerns," added the RCS.
"However, we have agreed that the Royal College of Surgeons' PAB would revisit Cardiff and Vale Health Board in September 2013 to assess what progress has been made."
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