Trust’s A&E rated “inadequate”

But Sir Mike Richards says it has ”turned a corner”

Chief executive on “emergency leave”

PERFORMANCE: The Care Quality Commission has rated a trust’s accident and emergency department ‘inadequate’ but said it had ”turned a corner” and made improvements since April.

North Middlesex University Hospital Trust in north east London was inspected by the CQC in April in response to concerns raised by Health Education England, the General Medical Council, MPs and the media.

HEE had threatened last month to withdraw trainee medics from the trust, saying they were being asked to undertake work they were not prepared for and did not have proper supervision. North Middlesex has had difficulty recruiting middle-grade and consultant emergency department doctors.

The report released today rated the service “inadequate”, the lowest possible rating, but also said that when inspectors revisited the trust last week they found evidence of progress.

Chief inspector of hospitals Sir Mike Richards said: ”We have already seen some progress since that original [April] inspection. A new leadership team is in place in the emergency department, there are moves to appoint more senior doctors – and I note that the trust is calling on consultants from other departments within the hospital to provide the routine daily support to A&E which is so badly needed.

“The evidence from our latest inspection last week is that North Middlesex’s emergency department has turned a corner, but there is still much more that needs to be done. We will be watching their progress very closely.”

North Middlesex chief executive Julie Lowe has been on “emergency leave” this week.

The latest publicly available A&E statistics, for April, put the trust’s performance at 72.6 per cent against the target that 95 per cent of patients be seen within four hours. This is the lowest of any trust in the country, but up five percentage points from its position in February.

The CQC said at the April inspection the A&E department had not had a clinical director for more than six months and that ”trust management was seen as overbearing and unsupportive to staff. The culture meant that staff did not feel comfortable in raising concerns”.

A new clinical director was appointed to run the emergency department last week. Turan Huseyin was previously clinical director for the emergency department at Barnet Hospital, which is run by the Royal Free London Foundation Trust.

The Royal Free signed a memorandum of understanding with North Middlesex in March to explore closer working and the partnership board between the trusts has met once.

NHS Improvement has been working with other trusts to try and persuade them to lend emergency department staff to North Middlesex. HSJ understands it has received staff from Barts Health Trust and the Royal Free.

Royal Free chief appointed accountable officer at neighbouring trust