Four east London urgent treatment centres have been rated inadequate and placed in special measures by the Care Quality Commission (CQC). The services, which are run by the Partnership of East London Co-operatives (PELC) Limited under contract from the NHS, are: King George's Emergency Urgent Care Centre in Goodmayes, Queens Urgent Treatment Centre in Romford, Harold Wood Urgent Treatment Centre in Harold Wood, and Barking Urgent Treatment Centre in Barking.
Following inspections in October and November, CQC inspectors found the quality and safety of care provided to people at the services had deteriorated compared with previous inspections, leading to each service being rated inadequate. Staff shortages, long waiting times, and concern over patient safety were among the key issues identified, according to the inspection reports published today.
The inspections found:
- PELC could not be assured it was providing safe care to people, particularly those with potentially serious conditions
- There were insufficient procedures and processes to ensure learning from incidents and complaints. There were not clear systems in place to demonstrate improvements when things went wrong
- The effectiveness and appropriateness of care was routinely reviewed, and care and treatment were delivered according to evidence-based guidelines. However, targets specified by its commissioners were not being met
- There were insufficient procedures to ensure there was effective staffing
- Patients were not able to access care and treatment at the service in a timely way
- Leaders did not have the capacity and skills to deliver high-quality, sustainable care
- There were some clear responsibilities, roles and systems of accountability to support good governance and management. However, lines of accountability and designated decision-making authority were unclear
- PELC lacked a clear vision and credible strategy to deliver high quality care and promote good outcomes for patients through the services
On the positive side, CQC inspectors also found that staff involved and treated people with compassion, kindness, dignity, and respect.
CQC: People Didn't Receive Care and Treatment in a Timely Manner
Three of the four CQC inspections were undertaken to assess whether improvements which previous inspections identified as being needed had been made. King George's Emergency Urgent Care Centre was previously rated 'good', while the other services were rated 'requires improvement'.
The inspections also formed part of a follow-up on CQC's system-wide review of urgent and emergency care services across the North East London integrated care system, carried out in November 2021. The services will continue to be monitored to see if directed improvements are being made.
Commenting on the latest inspections, Jane Ray, CQC deputy director for London, said: "We found people didn't receive care and treatment in a timely way at PELC’s services.
"Although each service suffered from short staffing, which was a factor behind the long waits and an issue affecting the NHS more widely, PELC's leaders must prioritise meeting NHS England's standard of clinically assessing people within 15 minutes of arrival. This is to ensure those with the most critical needs receive urgent care and treatment.
"Behind this was the failure of the service's leaders to effectively monitor issues the services faced, including waiting times, to inform their strategies to meet people's needs. They also failed to capture learning when things had gone wrong to drive improvement," Ms Ray said.
"However, despite the pressure they were under, staff in each service treated people with kindness, respect and compassion. They involved people in decisions about their care and ensured their dignity.
Actions Taken to Improve Services
In a statement toMedscape News UK, Zina Etheridge, chief executive of NHS North East London, which commissions the urgent treatment centres run by PELC, said: "Following the CQC inspections of the four urgent treatment centres run by PELC, health and care partners in north east London took immediate action to address the concerns raised and are now working closely together to make improvements.
"Ensuring initial clinical assessments are carried out within agreed, safe timelines, and that patients are more closely monitored while they wait to be seen are key issues addressed in a coordinated plan agreed by all health and care partners locally.
"Together with improvements to the way the organisation is managed and a new plan for managing capacity and demand, our plans will help us tackle the long waits and mean we provide better safer care for patients."