CQC warns Queen’s Hospital in Romford that its emergency department is still failing to meet patients’ needs

The Care Quality Commission has told Barking, Havering and Redbridge University Hospitals NHS Trust that it must make urgent improvements to the emergency department at Queen’s Hospital in Romford.

CQC has issued a formal warning to the trust following an unannounced inspection at which it failed to meet two of the three national standards which were reviewed.

A team of inspectors spent two days at the hospital in May to check if improvements had been made in response to the major concerns which were identified at an inspection in December 2012. They were supported by an A & E nurse, an A & E consultant and an Expert by Experience – a person with experience of using services. A full report of this inspection has been published on the CQC website, read the full report here.

At the latest inspection, CQC inspectors found that patients who arrived at the hospital by emergency ambulance were waiting too long to be assessed. During April, one in 20 people were waiting 45 minutes even though patients should be seen in 15 minutes.

Matthew Trainer, Regional Director of CQC in London, said:

"The emergency department at Queen's Hospital in Romford is failing local people. This situation has been going on for far too long. Radical thinking is needed, led by the Trust Development Authority and commissioners. The trust’s Board needs to work with them to make sure patients get the care they deserve.

“Patients are entitled to be treated in services which are safe, effective, caring, well run, and responsive to their needs. We have seen several recovery plans come and go in the emergency department at Queen’s and there is little evidence of any impact.

“The fundamental problems we first raised in 2011 – not enough doctors in the emergency department, and unacceptable delays in getting specialists from elsewhere in the hospital to see people admitted through A & E – are still there. This means excessive waits and ambulances being diverted to other hospitals. The staff who work there told us they feel under siege despite their best efforts to deliver good care.”

In the first four months of the year, there were multiple occasions where ambulances had to be diverted away from Queen’s to other hospitals in London. Some patients waited more than an hour between arriving in an ambulance and being handed over to a doctor.

The trust has not had enough permanent consultants or middle grade doctors for several years. Their own data shows that use of non-permanent staff creates delays and they have not managed to address this issue. At the time of the inspection, the average waiting time for consultations with a specialist was more than three hours, even though the trust’s own policy is that all patients should be seen by a specialist doctor within 30 minutes.

On some occasions, patients who needed to be admitted to the hospital were waiting more than 14 hours in the emergency department because there were no beds available. Some of the problems identified had been ongoing for more than two years with little improvement.

Inspectors found that, while people were still spending far too long in the emergency department, there had been some improvements in the availability of food and drink and delivery of personal care while they were waiting.