"Severe concerns with regard to patient safety..."

We attended the paediatric a&e department on a Sunday at approx 6pm. The RCPCH and RCEM deem that all children and young people should have an environment which is age appropriate with sufficient toys and games. In the entire department there were a total of 5books, 2of which were annuals and damaged, 1 broken activity cube and one broken electronic toddler toy. The sensory wall only installed in Nov also no longer works. More concerning is the lack of visibility of the waiting area and failure to triage by a registered practitioner for over 1hr ( the prescribed standard is 15mins). Until this point the only point of contact is the receptionist with no clinical ability to prioritise. The waiting area was packed with children and families decanting to the floor, a nurse appeared to triage approximately once every 25-30mins but never set eyes in the waiting area in between. My main concern is that should a child be triaged category 1or 2 they could potentially be getting more unwell and/or risk cross-infection secondary to this. A more formal visible waiting area/triage system needs implementing as a clinical priority before a patient comes to significant harm.

This is a real possibility with the current system. I would like to see relevant audit results for all patients including time/date of registration, time to triage/ time to clinical decision made to see if this indeed the norm and not an 'outlying' day.