Wednesday, 17 September 2014

Failing A&E swamped by 8,000 patients... from axed casualty units up the road: Inspector's damning report warns of 'avoidable harm' at overstretched hospital

  • Northwick Park Hospital in Harrow, London, will soon have to deal with at least 8,000 more patients a year due to the closure of two London units
  • Comes after the unit was criticised in an official report for being unsafe
  • Professor Sir Mike Richards said the hospital 'requires improvement'  
  • Central Middlesex A&E, which treated 14,000 patients a year, shut on Wednesday
  • So too did Hammersmith Hospital, which looked after 22,000
  • Both have been replaced with 24/7 'Urgent Care Centres'  
An accident and emergency unit criticised in an official report for being unsafe and unable to cope with demand is set to be swamped with thousands of extra patients – thanks to emergency department closures elsewhere.
The Chief Inspector of Hospitals painted a picture of chaos at ‘very busy’ Northwick Park Hospital in Harrow, North-West London, after a recent visit. 
But its A&E will soon have to deal with at least 8,000 more patients a year due to the controversial closure of two London units last week.

Hammersmith Hospital, which treated 22,000 patients, shut on Wednesday despite protests to keep it open
In his report on Northwick Park, Professor Sir Mike Richards, who leads the Care Quality Commission’s inspectors, found that:
- Its A&E had ‘inadequate staffing levels to protect patients from avoidable harm’
- Patients were ‘often “bedded down” in A&E’ – because there were no free ward beds
- Ambulances had to wait too long to off-load desperately sick patients – resulting in eight ‘serious incidents’ in just 14 months
- The department ‘struggled’ at periods of high demand and was ‘consistently not meeting the four-hour A&E waiting-time target’
- Staff morale was ‘low’ and senior management was ‘unaware of the issues within critical care’
Sir Mike concluded the hospital ‘requires improvement’ and left managers an urgent ‘to do’ list.

Ironically, one of the two A&Es that has just closed – at Central Middlesex Hospital – was ranked ‘good’ in the same CQC review.
‘The A&E department provided care and treatment that was safe,’ wrote Sir Mike and his team of inspectors after their visit to the hospital in Acton in May.
‘Staff expressed pride to be working in the A&E department.’
The Mail on Sunday has been campaigning for two years to save A&Es from closure. But Central Middlesex A&E, which treated 14,000 patients a year, shut on Wednesday. So too did the unit at Hammersmith Hospital, which treated 22,000. 
Both have been replaced with 24/7 ‘Urgent Care Centres’ (UCCs) – which have been criticised for offering a variable service, with some staffed by nurses alone at night.
Northwick Park Hospital in Harrow, North-West London, will soon have to deal with at least 8,000 more patients a year due to the controversial closure of two London units last week

NHS bosses hope the UCCs will be able to deal with A&E patients without life-threatening illness or injuries. They insist the ‘changes’ will improve care by centralising staff and resources.
They estimate the closure of Central Middlesex’s A&E will lead to another 8,300 patients going to Northwick Park – a ten per cent rise. But predictions following previous closures have been well wide of the mark. The closure of Chase Farm A&E in Enfield was expected to lead to 26,000 more patients at North Middlesex Hospital in Edmonton; that was recently revised up to 40,000.
Even if the forecast is right, doctors fear the extra patients could cause problems across the whole of Northwick Park. One said: ‘There was no slack in the system as it was.’
Hospital chiefs seemed nonchalant about the CQC report at a July board meeting. ‘Only one issue within the report, in relation to critical care, had not been expected,’ stated the minutes. ‘Otherwise there were no surprises.’

Central Middlesex A&E, which treated 14,000 patients a year, closed on Wednesday (file picture)
Gareth Thomas, MP for Harrow West, said: ‘Six months before these closures the trust said that it needed another 123 beds to meet local demand. I’m concerned A&E waiting times will continue to rise – as will waiting times for routine operations, as the hospital will be full up.’
Most Hammersmith A&E patients not dealt with by its UCC are expected go to St Mary’s Hospital in Paddington – which was itself working at ‘maximum utilisation’ over the summer.
Northwick Park and St Mary’s are being revamped to cope, said a spokesman for the NHS trusts that run them. A new £21 million, 40-bay A&E unit is opening at Northwick Park, and it will get 20 more ward beds. St Mary’s is getting extra staff and beds in A&E, a new 15-bed elderly care ward and an ambulatory care unit.
David McVittie, chief executive of North West London Hospitals, said: ‘We do not expect a large impact on Northwick Park as a result of the closure of Central Middlesex and Hammersmith A&E units.’










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