CQC inspection reveals delays encountered at Edmonton hospital because of bed pressure, reports James Cracknell

An inspection of North Middlesex University Hospital’s emergency department has found that some patients are “waiting too long” for treatment – but has not downgraded its overall rating.

The unannounced inspection of the accident and emergency (A&E) department by the health watchdog Care Quality Commission (CQC) took place in July and found that a lack of supply of beds at the Edmonton hospital was leading to backlogs, with some patients even being left waiting in ambulances.

However, CQC also found there was adequate staffing, premises were well equipped and clean, and that escalation processes were good.

Because the inspection focused on areas where issues had been identified previously, it was not wide-ranging enough to update the CQC’s rating for the department, hospital or NHS trust. Consequently, the department remains rated ‘good’ and the hospital and trust continue to hold a ‘requires improvement’ rating.

Nicola Wise, CQCs head of hospital inspection, said: “We found some patients accessing the emergency department at North Middlesex University Hospital waited too long for assessment and treatment, while others couldn’t always access the service when they needed it.

“One of the reasons for this was a lack of available beds elsewhere in the hospital where people could be referred for further care.

“We also found there were delays discharging patients from ambulances into the hospital, however there were good processes for identifying people who needed escalating through the queue.

“There were enough staff to meet people’s needs and keep them safe, and there was a very open culture where people could raise issues and make suggestions for improvement.

“We have shared our feedback with the trust about what it needs to address but are pleased to see good standards of care being provided to people overall.”

CQC has told North Middlesex University Hospital NHS Trust to work more closely with NHS ambulance services to review how ambulance crews can transfer patients into the hospital’s care more quickly.

In response, the NHS trust has reiterated that it is facing “major challenges” in emergency care, with this summer being its busiest ever amid “continued unparalleled demand for urgent and unplanned care and treatment”.

North Mid’s A&E department is one of the busiest in London, seeing more than 700 patients on some days. Like many hospitals across England, it is seeing patients with increasingly complex needs, and high numbers of ambulance arrivals.

Dr Nnenna Osuji, the trust’s chief executive, said: “Every member of North Mid’s urgent and emergency care service should be proud of the work they do every day, for everyone in our community, and I am grateful to the CQC for their report which highlights the immense commitment our staff show to our local patients, day in, day out.

“I am proud of our incredibly busy and hard-working team, from junior doctors, to phlebotomists, staff nurses and cleaners, and everyone who supports them to continue to go above and beyond every day.

“I am even more pleased for our local community that the CQC’s findings show North Mid continues to provide safe, well-equipped, highly skilled care and treatment for so many people, despite ongoing challenges of high demand and pressure.

“Like our hospital, which draws much strength from our brilliant north London community, our emergency department is embedded in a system which not everyone sees all the parts of. I do, and I want to extend my thanks to partners across the urgent and emergency care system, for their ongoing work to help us continue to improve.

“From rota co-ordinators to medical suppliers, to royal colleges, staff side, and educators, we are all one team, and I urge our local community and its leaders to work with us to use our emergency department wisely so that we can continue to look after people who need us most.

“This means making time to protect yourself from illnesses where possible, like flu and Covid, taking the chance to have vaccinations when you are offered them, and looking after family, friends and neighbours as we approach the winter period. Our staff are here for everyone, and we ask that you look after them too and treat them with kindness.”

The full CQC report is available to read online:
Visit cqc.org.uk/location/RAPNM

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