Hospital checks uncover strains on A&E units

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A TRIAL programme of inspections at 18 English hospitals uncovered significant strain on A&E units and found outpatient services were “unacceptably poor” due to significant waits for care.

The Care Quality Commission found “significant variations” in quality between and even within hospitals, but concluded there was a “lot of good practice” in critical care, maternity services and treatment of people with dementia.

Although 18 hospital trusts were inspected, including Harrogate and Airedale, only three were given trial ratings. Of these, two have been declared not good enough by inspectors.

The new-style inspections come in the wake of the Stafford Hospital scandal when the Government introduced Ofsted-style ratings for hospitals, with trusts rated to be outstanding, good, requiring improvement or inadequate.

Two – Heart of England and the Dartford and Gravesham trusts – were deemed to require improvement while the Royal Surrey trust was assessed to be good.

Sir Mike Richards, the new chief inspector of hospitals, said that despite compassion and care being “alive and well” in the NHS, there were “significant variations” in quality.

His inspection team concluded there was “a lot of good practice” in services including critical care, maternity services and care for people with dementia.

“However, inspectors found significant variations in quality between trusts and even between services within trusts,” the CQC said.

“Accident and emergency departments were found to be under greater strain than other hospital services. Some haven’t adapted to increased volumes of patients, which is leading to overcrowding, long waiting times and staff shortages at times.

“Outpatient services were poor – they were not responding well to patient needs across most of the hospitals inspected, with patients waiting unacceptably long times to be seen and some clinics being overcrowded as a result.

“The report also found that apart from critical care and maternity, most services cannot demonstrate whether they are delivering effective care or not.”

Inspectors found difficulties in the way patients were shipped between different parts of the hospitals and a “them and us” culture between doctors and managers.

Sir Mike said: “Ratings will be very helpful for patients, allowing them easy access to information about quality and allowing excellent hospitals to trumpet their own achievements.”