Worst trusts on A&E experience revealed by CQC

15 Comments

New CQC survey into patient experience in A&Es
Identifies six trusts which scored “worse than expected” and nine which were “better”
Many people positive about staff interactions but others concerned over lengthy waits

A Care Quality Commission survey has identified the trusts where the most patients report a bad experience in A&E.

The CQC surveyed more than 45,500 people who used NHS urgent and emergency care services in 2024.

It found that while many were broadly positive about their interactions with staff, there were often complaints of long waits for assessment, and some patients were not given enough help to manage their pain or control symptoms.

The survey, published this week, identified six acute providers that achieved “worse” or “much worse than expected” results when compared with all other trusts across the full range of survey questions. Even these did have more areas where patients were “positive” than those which were negative, however.

The “worse than expected” trusts were Barking, Havering and Redbridge University Hospitals Trust, Croydon Health Services Trust, Wrighton, Wigan and Leigh Foundation Trust, Barts Health Trust and United Lincolnshire Hospitals Trust. Around a quarter of responses to questions at these trusts were the “most negative” possible answers.

East Lancashire Hospitals Trust was the only trust to be identified as having “much worse than expected” results in the survey – with 28 per cent of responses to questions being the “most negative”.

East Lancashire had the lowest of any “overall experience” rating of 6 out of 10. Nationally, urgent and emergency care had an overall experience rating of 7.3 (see the full list of overall experience ratings below).

Trusts achieving ‘worse’ or ‘much worse than expected’ A&E patient experience

	National comparison	Most Positive	Middle	Most Negative
National average		61%	20%	19%
East Lancashire Hospitals Trust	Much worse	48%	24%	28%
Barking, Havering and Redbridge University Hospitals Trust	Worse	53%	22%	25%
Croydon Health Services Trust	Worse	51%	24%	25%
Wrightington, Wigan and Leigh FT	Worse	54%	22%	24%
Barts Health Trust	Worse	54%	22%	24%
United Lincolnshire Hospitals Trust	Worse	53%	23%	24%

Barking, Havering and Redbridge trust CEO Matthew Trainer, where headline A&E waits have reduced substantially over the past 18 months, said the trust’s results “don’t reflect the work we’ve been doing to improve the experience for patients in our A&Es”.

He added that patients will continue to face A&E delays and spend nights in corridors until the trust gets the money to build a bigger A&E at Queen’s Hospital in Romford.

Jawad Husain, executive medical director at East Lancashire Hospitals, apologised for the long waits and said the results “clearly reflect the challenges we have around the sheer numbers of people coming into the department”. Barts Health Trust vowed to improve patient flow to give patients a better experience.

Croydon Health Services and United Lincolnshire both pledged to make improvements to patients’ experience in emergency care.

Trusts achieving ‘better than expected’ A&E patient experience

	National comparison	Most Positive	Middle	Most Negative
National average		61%	20%	19%
Moorfields Eye Hospital FT	Better	73%	15%	12%
Homerton Healthcare FT	Better	72%	15%	13%
South Warwickshire University FT	Better	71%	16%	13%
Royal Devon University Healthcare FT	Better	71%	15%	14%
Guy’s and St Thomas’ FT	Better	70%	17%	13%
James Paget University Hospitals FT	Better	70%	17%	13%
University College London Hospitals FT	Better	70%	16%	14%
Royal United Hospitals Bath FT	Better	69%	16%	15%
Chelsea and Westminster Hospital FT	Better	69%	17%	14%

The CQC also highlighted nine trusts which delivered “better than expected” results for A&E patient experience when compared with their peers. They include the specialist Moorfields Eye Hospital FT and eight acute trusts, where around seven in 10 responses were the “most positive” possible answers.

Nationally, the survey found patients were more likely to be positive about their interactions with staff if they attended an urgent treatment centre than if they went to a major emergency department.

It found that less than half of people attending either an A&E (42 per cent) or an urgent treatment centre (47 per cent) who needed help with pain relief thought staff “definitely” helped them control their pain. Two-thirds of people discharged from A&E (67 per cent) said they were given information on how to care for their condition at home, and a third (33 per cent) said they were not.

Not being able to get a GP appointment quickly enough and wanting to be seen on the same day were both factors directly influencing people’s decisions to seek treatment at an urgent and emergency care service, the CQC found. Of those who went directly to A&E, 20 per cent went because they thought their GP practice would not be able to help (UTC 21 per cent), and 26 per cent wanted to be seen on the same day.

Chris Dzikiti, CQC’s interim chief inspector of healthcare, said: “The results demonstrate how the stream of demand is continuing to drive lengthy waits and cause difficulty for some patients in accessing information, emotional support and adequate pain relief. They also show the impact for staff when the number of people seeking urgent and emergency care is so high and resources are stretched.”