Published: 10/01/2001, Volume 112, No. 5787 Page 9

The Commission for Health Improvement is to carry out an urgent review of Surrey and Sussex Healthcare trust following concerns about accident and emergency services after the death of a man who was left without medical attention for 18 hours despite having a serious head injury.

Eighty-two-year-old Edward Crosfield was taken to East Surrey Hospital following a fall at his home at the end of 2000. At the inquest, Mr Crosfield's sonin-law, Dr Robin Toquet, the head of accident and emergency services at St Mary's Hospital, Paddington, attacked the 'appalling treatment' which he said was an indictment of the pressures on the NHS.

The coroner recorded a verdict of accidental death in which neglect was a contributory factor.

CHI has announced that it will fast-track the clinical governance review of the trust 'in the light of concerns about the quality of accident and emergency services and communication between staff '.

A CHI spokesperson said that Mr Crosfield's death would not be investigated specifically but the review would 'focus on staff communication and quality of care in A&E'.

A spokesperson for the trust said an internal investigation had identified communication problems which had been immediately addressed 'in such a manner that the events could never happen again'.

Meanwhile, CHI has highlighted poor leadership and communication and concerns over patient safety at two other trusts.

King's Lynn and Wisbech trust won praise for its 'open culture where staff feel able to report things that have or could go wrong'. But CHI concludes that the trust has 'not always used these opportunities to correct problems or improve patient care'.

Although the trust demonstrates examples of effective clinical care, CHI found that 'leadership and communication within the trust, especially between managers and clinicians, needs to improve'.

These shortcomings were particularly apparent when staff shortages led to bed closures or occasions when there was just one trained nurse on a ward. The trust will publish an action plan to tackle the problems by the end of January.

At Scarborough and North East Yorkshire trust, CHI called for 'immediate attention' to 'numerous concerns' about patient care at Bridlington and District Hospital, including weekend surgery, post-operative supervision, nurse and junior doctor staffing, and anaesthetic cover during transfer from Bridlington to larger units The trust said that following CHI's visit in August a new coronary monitoring unit had been opened, staffing levels had been increased and that it was 'reassessing the risk' relating to anaesthetic cover.