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North Middlesex Hospital’s emergency department has been ordered to improve by the Care Quality Commission
A patient lay dead for up to four-and-a-half hours before being spotted at one of the busiest’s AE departments in the country, inspectors have revealed.
On one occasion there was only one commode available for more than 100 patients at North Middlesex University Hospital, a report by the watchdog said.
Emergency services at the London hospital have been rated “inadequate”.
The hospital said it was “extremely sorry” for the problems in the unit.
Inspectors from the Care Quality Commission said there were too few competent doctors who were able to assess and treat patients at night when they inspected the department in April and May.
‘Fear of retribution’
The unit – which sees 500 hundred patients a day – logged 22 serious incidents in the past year, including the dead patient not being found for hours.
Others included a patient being left sitting on a bedpan for more than an hour.
And nurse to patient ratios were rarely achieved because they frequently had 20 patients being treated in the corridor.
The report also said staff were afraid to speak up for fear of retribution.
The inspection of the emergency department and two of the hospital’s medical wards was in response to concerns about the standards of care.
The hospital has apologised to patients and says the AE department now has five additional doctors and consultants on loan from other London trusts, a new nursing lead and new clinical director.
Chief Inspector of Hospitals Sir Mike Richards said the hospital has already “turned a corner” since the inspection.
He said: “A new leadership team is in place in the emergency department, there are moves to appoint more senior doctors – and I note that the trust is calling on consultants from other departments within the hospital to provide the routine daily support to A and E which is so badly needed.
“There is still much more that needs to be done. We will be watching their progress very closely.”
The report found:
- There were significant delays to repairs of essential equipment
- Middle grade nurses assessed patients arriving by ambulance, without input from doctors
- Patients were not fully covered up on trolleys in the corridor, affecting their dignity
- The department was without an established clinical director to provide leadership for more than six months
- Inspectors said there were “no areas of outstanding practice”
David Burrowes has first-hand experience as a patient at the department after his appendix ruptured in 2014
David Burrowes, MP for Enfield Southgate, said he was left to wait for 12 hours on a trolley with a ruptured appendix in the emergency department in 2014.
He said “urgent action” was needed.
“The important question is why the warning signals from at least two years ago were not heeded,” he added
Tottenham MP David Lammy said the “damning” report is “even worse than I feared” and demanded answers from Health Secretary Jeremy Hunt.
He said: “It shocks and appals me that this situation has been left for so long without an intervention from the Health Secretary, and the way that this has been covered up is nothing short of a scandal.”
During the same inspection, medical care services were rated as requiring improvement.
The trust is now required to improve the care of patients in the emergency department by 26 August 2016 following a warning from the CQC.
A full inspection of the trust will take place in September.
David Lammy says his calls for answers from Secretary of State for Health Jeremy Hunt have gone unheard