The Care Quality Commission (CQC) has rated urgent and emergency services at Queen’s Hospital and King George Hospital requires improvement following inspections in October and November.
These inspections were carried out to follow up improvements CQC told the trust to make following a previous inspection of urgent and emergency care in November 2022.
At Queen’s Hospital, the rating for urgent and emergency services has now been raised from inadequate to requires improvement overall, as have its ratings for safe and responsive. Its ratings for caring and well-led have been raised from requires improvement to good. Its rating for effective has been again rated good.
At King George Hospital, the rating for urgent and emergency services has also now been raised from inadequate to requires improvement overall, as have its ratings for safe and responsive. Its rating for well-led has been raised from requires improvement to good. This service wasn’t previously rated for effective and caring, and these are now rated good.
The ratings of both hospitals overall remain requires improvement, as does the rating for Barking, Havering and Redbridge University Hospitals NHS Trust.
Jane Ray, CQC deputy director of operations in London, said:
“When we inspected urgent and emergency services at Barking, Havering and Redbridge University Hospitals NHS Trust, we found improvements had been made since our last inspection to reduce waiting times and improve people’s safety. However, further improvements were needed.
“For example, we found both emergency departments had risks in their system for managing time critical medications, and not all staff had up-to-date mandatory training in areas such as life support and resuscitation.
“Staff told inspectors about a lack of capacity in inpatient wards, as well as the wider local health and care system, leading to longer stays in the emergency department. This meant some people were still being cared for in corridors at the busiest times, but the trust had implemented new guidance to make sure this was done safely and with as much privacy as possible.
“At both emergency departments we found management had improved and leaders understood the challenges they faced. Staff were compassionate in providing care and worked together well to meet people’s needs.
“We’ve told the trust where improvements still need to be made, and where there’s good practice to build on. We’ll continue to monitor these services, including through further inspections, to make sure people receive safe care.”
Inspectors also found:
At both locations:
- People needing mental health care had particularly long waiting times before being assessed by approved mental health staff
- Mental health rooms for children contained ligature points, meaning staff had to observe the children in these rooms at all times, impacting their privacy.
In urgent and emergency services at Queen’s Hospital:
- The layout of the children’s emergency department meant people outside the resuscitation room could often hear children receiving treatment inside. This could be very distressing, including for the child’s loved ones
- Some people’s records weren’t kept securely to maintain their privacy
- Some people’s records didn’t always detail their risk assessments.
In urgent and emergency services at King George Hospital:
- People’s medicines records didn’t always contain all relevant details, such as people’s allergies
- Staff didn’t always report the use of rapid tranquilisation for people whose distress could be a risk to themselves or others as an incident, risking a lack of oversight of this by trust leaders.