‘We do not run our front door’, says CEO of ‘inadequate’ A&E

The CQC said on Friday it was downgrading the rating of urgent and emergency care services  at Barking, Havering and Redbridge University Hospitals Trust from “requires improvement” to “inadequate”, for both its King George and Queen’s hospital sites.

It said patients faced delays getting care and in being moved to specialist wards or mental health facilities.

BHRUT chief executive Matthew Trainer told HSJ  he felt the report was “fair”, but also highlighted problems with the UTCs as a major cause.

UTCs at both King George and Queen’s hospitals are run by the Partnership of East London Co-operatives. Both of them, along with two other PELC-run UTCs in north east London, were placed into special measures by the CQC last month, because of several problems and a “failure” of leaders to address them.

Mr Trainer said: “We work closely with PELC, and we do our very best with them to try to give people the best experience we can, but we are the only trust in north east London that does not run its own front door, and that does create problems for us at times.”

He told HSJ  he did not want his trust to run the current UTCs, but that North East London integrated care system, which commissions PELC, should review the current model.

He added: “Sometimes people can face quite a long wait for PELC and they then face a long wait when they come through to us. People do not recognise they have been waiting for two providers, and why should they?

“What they think is: ‘I have spent a very long time in King George Hospital, or Queen’s Hospital, in A&E.’

“It is a difficult arrangement, and it is one that we try our best to deal with in the circumstances we are in, but I think it is part of that series of frustrations about the way the systems are designed around here.

“That is no fault of the folk who are working at PELC at the minute to try and make this better, but I do not think the commissioning arrangements around the urgent treatment centre are delivering the service that people here deserve.

“We need to work more closely with them to try to get this whole front door interaction, between the urgent treatment centre and the hospital, into a better place.”

Zina Etheridge, chief executive of North East London ICS, told HSJ that “immediate action” was taken to address the issues following the CQC’s visit.

She said: “A number of measures have already been put in place and are having an impact. By working together with our partners, we will tackle the long waits and ensure we provide better, safer care for patients.”

PELC did not respond when asked if it wanted to comment.

BHRUT’s performance on accident and emergency targets has consistently been at or close to the bottom of acute trusts for several years. In December, only 28 per cent of type one attendees were admitted, transferred or discharged within four hours, the lowest of any English trust. 

Mr Trainer said last August he would take a “hard look” at himself if sustainable improvements had not been made within a year.

The CQC did not change the trust’s overall ”requires improvement” rating in its report published on Friday. It said that, overall, BHRUT had an open culture and that patients were treated with compassion and kindness.