Basildon and Thurrock University Hospitals Foundation Trust has been given a formal warning by the Care Quality Commission, after unannounced inspections found triage times for children were being breached.
The inspections followed the death of an infant who was not assessed within the 15 minutes target time at the trust’s paediatric accident and emergency department. He was stabilised and transferred to a specialist children’s hospital but deteriorated and died after treatment was withdrawn.
Inspectors looked at four care records for children attending the hospital’s A&E and found the 15 minute waiting time for triage had been breached in every case.
They also raised concerns about ineffective systems to learn from incidents which could lead to patient harm, and a failure to identify and manage risks to patients. The inspectors questioned whether monitoring and assessment of services would ensure that patients who were deteriorating would be recognised.
The trust was given a formal warning over failure to monitor the quality of service provision. The CQC also had concerns over care and assessment of service users - and issued a separate warning over this - but when it reinspected in August it found some improvements in this.
Andrea Gordon, deputy director of operations (regions), said: “Our inspectors will return in the near future and if we find that the required progress is not made we won’t hesitate to use our legal powers to protect the people who use this service.”
Trust chief executive AIan Whittle, who is due to leave the trust shortly, said: “The main area of improvement relates to the early initial assessment of patients in A&E, particularly for children, in order to identify those at greatest risk of deterioration, and therefore in need of urgent treatment.
“The need to make changes in this area was identified by the trust, following a serious incident investigation in May. For the five weeks since the beginning of July, over 98% of the 1,600 children attending A&E had a full, detailed clinical assessment within 15 minutes, and the remaining 2% had a rapid assessment within 10 minutes of arrival.
“We are intent on maintaining this standard of service, and are recruiting additional children’s nurses for the department.”