Fears About Overstretched Accident and Emergency Units

Ealing Council 'deeply concerned' at local casualty provision

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A new report raises more concerns about overstretched Accident and Emergency units in North West London.

The inspection carried out by the Care Quality Commission (CQC) of services at Chelsea and Westminster Hospital NHS Foundation Trust found an increased demand including in its accident and emergency (A&E) service.  It also found that the A&E did not have the recommended levels of medical staff working there.

Hospital staff told inspectors they believed the reconfiguration of services across London had contributed to the increase in demand.   The inspectors said they had no evidence to support this view.

On 10 September, two A&E services in the region, at Central Middlesex and Hammersmith hospitals, were closed as part of the NHS’s plans to rationalise services across north-west London. This meant that people who previously used A&E services at these hospitals now have to use services at the remaining hospitals in the region, including Chelsea and Westminster Hospital NHS Foundation Trust.

Inspectors rated accident and emergency, medical care, surgery, children’s care, end-of-life care and outpatient services at the Chelsea and Westminster as ‘requires improvement’. Critical care and maternity and family planning were rated as ‘good’. CQC rated the hospital as ‘requires improvement’ overall.

In August, the CQC released a report about services provided by North West London Hospitals NHS Trust. It identified a number of areas where Northwick Park Hospital needed to improve including ensuring there were enough staff to deal with A&E patients.  It also wanted the trust to put in place better systems to assess and monitor the quality of A&E services to make sure they were safe and could be benchmarked against national standards.

In addition to the closure of A&E services at Central Middlesex and Hammersmith Hospitals the NHS intends to downgrade A&E services at Ealing Hospital and Charing Cross Hospital – leaving the area with five major hospitals with fully-functioning A&Es.

Councillor Julian Bell, leader of the council said: “This is the second report in as many months where the chief inspector of hospitals has highlighted concerns about the remaining A&E services in our area.  Since the plans to shut A&Es were announced, I have expressed concerns about the ability of the remaining A&E services to cope with extra demand in patient numbers and this second report confirms my fears.

“We are committed to ensuring that our residents have access to the best possible health services available.   I will now be writing to the secretary of state for health to reiterate the very real concerns that this council has about the NHS’s plans for accident and emergency services in this area and ask that he assures us that patient safety is not put in jeopardy by further reconfiguration.”

Councillor Hitesh Tailor, cabinet member for adults, health and wellbeing, said: “This report tells us that people who need to be seen quickly are waiting longer to be assessed and treated and that there aren’t enough medical staff working in A&E.   

“This is unacceptable and raises serious concerns about the NHS’s plan to reduce services further.  On reading this latest report, I am deeply concerned about the ability of A&E services to cope as we enter the winter period, when demand normally increases.”

Specialist HIV and sexual health services provided by Chelsea and Westminster Hospital NHS Foundation Trust were rated as ‘outstanding’. Inspectors found that staff were caring and compassionate and treated patients with dignity and respect, and the majority of patients said their experiences of care were good.

The full reports on the trust and on the hospital are available from: http://www.cqc.org.uk/location/RQM01.



28th October 2014