To consider any items admitted at item 3 above.
Minutes:
Jill Shattock, Director of Performance, Haringey CCG, informed the Panel that following an unannounced inspection by the Care Quality Commission (CQC) in April, the Chief Inspector of Hospitals had published a report in July concerning urgent and emergency care services at North Middlesex University Hospital. The Panel was informed the service had been rated as inadequate.
The following points were noted:
- The inspection, of the emergency department and two of the hospital’s medical wards, had been in response to a number of serious incidents which had raised concerns about the standards of care.
- At the time of the inspection, CQC inspectors had raised immediate concerns, and subsequently issued a Warning Notice requiring the trust to significantly improve the treatment of patients attending the emergency department.
- The CQC had been working closely with colleagues at NHS Improvement, NHS England, Health Education England and the General Medical Council to ensure patient safety improved.
- The hospital, together with partners, had launched a new programme, known as “Safer, Faster, Better”. It was noted that this had been designed to speed up the flow of patients through A&E and to help achieve the national target of seeing, treating, admitting or discharging 95% of patients within four hours.
- The hospital’s A&E department was one of London’s busiest, seeing around 500 patients a day. The Panel was informed the hospital had met, or came close to the 95% target, until July 2015.
- The trust had developed an action plan setting out the steps it would take to address concerns identified in the Warning Notice and report.
Ms Shattock advised that the hospital had begun a programme of improvements to address concerns, such as delays in patients seeing a doctor, the need for greater leadership in the Accident and Emergency (A&E) department, and staff morale. This included:
- Appointing a new clinical director of the hospital’s A&E department who had started on 27 June.
- Appointing a new nursing lead in A&E who had previously led improvements in other A&E departments.
- Gaining five additional middle grade doctors and consultants on loan from other London trusts to bolster its A&E medical team.
- Improving communication with patients, families and other stakeholders.
- Greater collaboration with community care providers in order to speed up the discharge of patients.
The Panel was informed the hospital would receive support in making further improvements from Royal Free London. It was noted Julie Lowe, Chief Executive, had resigned and that Libby McManus, from the Royal Free and previously interim Chief Executive at Chelsea and Westminster Hospital, had agreed to take on the role of interim Chief Executive at North Middlesex, with David Sloman, Chief Executive of the Royal Free, taking on the role of accountable officer on an interim basis.
In response to questions, Ms Shattock commented the CQC would revisit in September and the Panel was assured that findings would be available for public scrutiny. The Chair advised that the Adults and Health Scrutiny Panel had been invited to attend, and take part in, Enfield’s Health Scrutiny Committee on 5th October. It was noted Enfield had already agreed to monitor the CQC action plan and it was agreed that working in partnership would avoid duplication of resources.
AGREED:
That the urgent update from the Director of Performance, Haringey CCG, be noted.