- Inspectors downgrade safety and leadership to inadequate.
- They raised concerns about how patients are processed from arrival to treatment.
- However, commissioners say it is an ‘essential service’.
A privately run emergency and urgent care centre at an Essex hospital has been put into special measures by the Care Quality Commission after it rated the service inadequate.
King George’s Emergency Urgent Care Centre in Ilford is operated by the Partnership of East London Cooperatives, a community benefit society made up of GPs, patient representatives and other health professionals.
The CQC said safety and leadership had got worse since March 2017 with both now rated as inadequate.
The concerns over the safety of the service stemmed from leadership problems, with the inspectors reporting “the delivery of high quality care was not assured by the governance arrangements in place”.
The EUCC is co-located with the King George’s Hospital emergency department run by Barking, Havering and Redbridge Hospital Trust. Patients are seen by a nurse first before they are sent for treatment within the EUCC or transferred to the hospital’s emergency department.
CQC inspectors found this streaming process was flawed, saying it “did not safely assess, monitor or manage risks to patients”.
The inspectors were concerned about the detection of sepsis. This was “hindered by a lack of blood pressure monitors and child oxygen saturation probes in clinical rooms”. The service’s clinical policy for streaming failed to reference sepsis and there were delays in the process of assessing and recording clinical observations, during which a patient could deteriorate. In the case of sepsis, “this delay could compromise life”.
Inspectors found that the EUCC did improve its processes after safety incidents. However, there were limited opportunities for staff to discuss and share experiences from these significant events, meaning inspectors “could not be assured that learning included all relevant people”.
The CQC found there was no system in place for drawing together and distributing information about how to improve the service after safety incidents that fell below the threshold requiring reporting to commissioners. Therefore, issues that could mean services were not safe or effective were not identified or managed adequately.
The EUCC was rated as requires improvement for effectiveness of service and caring, both unchanged from the previous inspection. However, it maintained a good rating for responding to people’s needs. The inspectors also found staff treated patients with “compassion, kindness, dignity and respect”. The EUCC’s commissioner said the centre provided an “essential service” that eased the burden on hospital emergency departments.
Dr Shazia Mariam, medical director at PELC said: ”As an organisation, patient safety and quality of care remain our top priorities, and we are taking the report very seriously.
“While we know we have more to do, we are making good progress. We have already made significant changes, including improving our medicines management system, engaging clinicians to be more active in clinical audits and taking steps to make sure that patients are streamed appropriately and safely by live feedback, audits and joint clinical pathway development with BHRUT. There is now also a new front door to the EUCC, designed to address the privacy issues identified, and we have introduced a new model for shared learning to all clinical areas, as well as working to improve staff awareness and training around incident reporting.
“This is a disappointing and an unexpected outcome but having being placed into special measures, we will now draw on the additional support available to drive further improvements and make change happen.”