An Accident and Emergency sign on the outside of a hospital

Safety in A & E questioned

North Middlesex Hospital’s Accident and Emergency Unit has come under fire after concerns have been expressed regarding patient safety.

The A & E unit in North London took over the work of the neighbouring Emergency Department of nearby Chase Farm Hospital in 2013. Since then staffing levels have not met the increasing needs of the location population and there is a particular shortage of experienced doctors at middle and Consultant grade. To try and mitigate the problems, five staff from neighbouring hospitals are moving over to try and help plug some of the gaps.

Patient safety concerns go back to 2014 and 2015 when two patients died as a result of mistakes in the department and two further patients died as a result of mistakes elsewhere in the hospitals.

Both mistakes in A & E arose as a result of a failure to diagnose acute illness in patients; the first suffering from pneumonia and the second sepsis. Both conditions are time critical in terms of treatment and management and any delays in identifying the condition or administering treatment can rapidly lead to death.

Concern about the department has reached the highest levels with the General Medical Council and Health Education England threatening to close the A & E department and a risk summit being convened to discuss the issue on 17 February 2016. Since then, questions have been asked in Parliament and an Improvement Plan put together.

The hospital was originally given until 26 August to make significant improvements to the quality of care it provides or further action including closure may occur.

In the meantime, Chief Executive Julie Lowe is reported to have now resigned following a recent Care Quality Commission (CQC) Inspection Report finding that the A & E unit was risking the health of patients by forcing them to endure excessive waits to see a doctor.

The report also said that middle grade doctors were endangering patients on night duty, and:

many…were unable or unwilling to make decisions about patients’ diagnosis and treatment.’

Other findings include:

  • Failure to undertake hourly rounds resulting in a patient lying dead for 4 ½ hour before being found
  • A patient being left sitting on a bedpan for more than an hour
  • One commode being available for more than 100 patients
  • Problems with nurse/ patient ratios which should be 1:4 but which were 1:10

The trust also stand accused of concealing the extent of cover provided by junior doctors when pressed by the Guardian. The emergency services at the hospital have also been rated inadequate by the CQC report.

Labour MP and former health minister David Lammy said:

Not only has the emergency department been left in the care of junior doctors, but it now emerges that all patients arriving by ambulance were assessed and treated by nurses without any input from a doctor at all.’

Contact a Clinical Negligence solicitor

Sadly pressures on NHS services can lead to mistakes and a lowering of the standard of care that patients can expect. If you or a family member have been affected by the issues discussed please contact a member of our Clinical Negligence Team on 0800 316 8892 or e-mail marguarita.tyne@clarkewillmott.com and we will be happy to discuss this with you.

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