The Care Quality Commission (CQC) has raised serious concerns after an unannounced inspection at Royal Cornwall Hospital revealed harm to vulnerable patients placed in makeshift care areas during A&E surges.

The report highlighted multiple incidents, including a 96-year-old woman who died after a fall in a “temporary escalation space,” a patient with delirium who fractured their collarbone, and another patient who required intensive care after deteriorating in a “fit to sit” area.

Inspectors also found that ineffective handover processes meant staff were unaware of key risks to patients in these overflow zones. While Royal Cornwall Hospitals Trust stated it has already implemented immediate changes, the findings underscore the risks posed by temporary spaces under pressure. Despite the concerns, the CQC noted improved patient flow and praised staff for their commitment during challenging conditions.

Cracks in the System: NHS Estates Backlog Deepens

Meanwhile, the NHS continues to face mounting infrastructure challenges, with the total maintenance backlog for healthcare estates approaching £14bn.
As part of the national financial framework, capital allocations are being reduced by up to 10% in areas that exceed revenue spending thresholds. Some of the regions most affected by the estates backlog are now also facing capital cuts- including a £10m reduction in Greater Manchester and £3m in Nottingham and Nottinghamshire. The impact on South West London is yet to be confirmed.

The policy aims to encourage financial discipline, but system leaders warn it places further strain on already stretched capital budgets and may hinder investment in essential infrastructure, putting long-term safety and service delivery at risk.

‍