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CQC orders London trust to improve A&E services

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The Care Quality Commission has taken the step of telling a North London trust to improve its accident and emergency performance in the wake of an inspection.

The CQC issued a statement on Monday morning saying that the chief executive of North Middlesex University Hospital NHS Trust, Julie Lowe, had been told to improve A&E services.

“We found that patients were not receiving the quality of care that they should have been”

Edward Baker

The trust, which provides services in Edmonton, was inspected in April and the regulator has now issued a warning notice requiring the organisation to “significantly improve the treatment of patients attending the emergency department”.

The CQC said the unannounced inspection found the treatment model for patients was “not effective”. Inspectors found delays in the initial assessment of patients, in their medical assessment and in moving them to specialist wards and that there were insufficient middle grade doctors and consultants.

NHS England data shows North Middlesex treated 82.8% of type one patients within four hours in 2015-16. The national target is 95%. This was down nearly 10% from the trust’s 2014-15 performance.

It has previously been reported by Nursing Times’ sister title Health Service Journal that problems faced by the trust’s A&E were partly caused by Health Education England ordering that its junior doctors be given more supervision and time for training and less time delivering care, which had knock-on effects on the time available to higher grade doctors.

The CQC, which said it will publish a full report of its findings in due course, has given the trust until 26 August 2016 to make improvements.

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Edward Baker

In a statement, CQC deputy chief inspector of hospitals Edward Baker said: “People going to the emergency department at the North Middlesex University Hospital NHS Trust are entitled to a service that is safe, effective and responsive. We found that patients were not receiving the quality of care that they should have been.

“We have strongly encouraged the trust to engage with other organisations across the local health and social care system to resolve this challenging issue,” he said. “We will continue to monitor the trust closely, and will be returning for further inspections of the hospital to check that the service has improved.”

The trust will this week have its first partnership board meeting with the Royal Free London NHS Foundation Trust, as part of an arrangement to work as part of a hospital chain led by the Hampstead trust. The Royal Free is also exploring a buddying arrangement with West Hertfordshire Hospitals NHS Trust.

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