PERFORMANCE: A&E performance at Barking, Havering and Redbridge University Hospitals Trust is starkly divided at the trust’s two casualty units.

The A&E at King George’s Hospital saw 96.1 per cent of its 7,351 patients within four hours over the month running March 25 to April 21.

By contrast the A&E at Queen’s Hospital saw 80.3 per cent of its 11,903 patients within four hours over the same period.

The trust and commissioners plan to close the emergency department at King George’s as part of the Healthcare for North East London programme that has been approved by the Secretary of State.

The minutes of the last board meeting revealed some confusion over metrics and confusion among diorectors as to their responsibilities.

The minutes said: “[Non excutive director] Professor Anthony Warrens was concerned to see that the ratings on the [four-hour access improvement] plan were not consistent and this had been talked about quite a lot and had been held up as ‘real major progress’. It was obviously not as embedded in practice within the organisation, as the board had been led to understand.

“[Non executive director] Dr Maureen Dalziel referred back to the presentation by the clinical directors at the business planning sessions recently and raised the point that the other Directorates did not see the four-hour access performance as their problem, they saw it as the emergency department directorate’s problem and she had been disappointed not to see something presented by each clinical director that they were going to do to help improve the position.

“The board agreed with Dr Dalziel that the trust could not make the step change required unless everyone saw it as one of their problems too.”

The minutes also noted the board’s “huge disappointment” with the results of the Care Quality Commission’s A&E survey which saw “no improvements of note and in many areas worse scores”.

The minutes of the March meeting said: “It was agreed that there was a problem with the leadership in the emergency department. The board agreed that it was really distressing and very worrying that the trust had been scored the lowest trust nationally. It was a chronic problem that the trust had had for a long time and it was proposed that the organisation should bring in role models, as examples of first class care, from other trusts, or arrange for some trust staff to go and work in an emergency department where there was evidence of good clinical care.

“Everything the organisation did had to be focused around patients, and the Trust had to be better than others, in order to rebuild its reputation.”

Dr Derek Hicks stood down as clinical director for emergency care at the end of April “to concentrate on his clinical duties”, a spokeswoman told HSJ.