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Special measures: Report into Queen’s Hospital, Romford, finds eye patient had wrong surgery and sexual health clinic held ‘in cupboard’

Ambulance queues at Queen's Hospital Ambulance queues at Queen's Hospital

Wednesday, December 18, 2013
5:10 PM

An eye patient given the wrong surgery, sexual health patients being treated in a storage cupboard, waiting times of up to 18 hours and nurses who didn’t know how to recognise blood poisoning are among the sobering catalogue of failings uncovered by the latest CQC report into Queen’s Hospital.

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What are special measures?

• The trust must now publish an “Improvement Plan” listing the measures it takes to improve services, including who is leading on different actions. It will have its leadership reviewed, and it will be both supported and monitored. It might be given a “partner” from a better-performing trust, or more help from commissioners.

• The chief inspector of hospitals will visit Queen’s and King George again after a set period of time. If they have improved sufficiently, the trust will be taken out of special measures. If not, it could be placed into special administration.

South London NHS Trust won the grim accolade of being first in the country to go into administration when Matthew Kershaw from the Department of Health was appointed to run it in July.

It comes as the care watchdog recommends Barking, Havering and Redbridge NHS Trust be put into special measures – making it the 14th trust to be handed the sanction this year.

But the report also recognises good care of stroke patients and notes sustained improvements in the Romford hospital’s maternity unit following the transfer of services there from King George Hospital, Goodmayes, earlier this year.

The eye surgery blunder was one of three “serious, largely preventable patient safety incident” that took place between 2012 and 2013. The other two involved swabs being left inside patients following surgery.

“This incident involved a person undergoing a different surgical procedure [from] the one they had consented to,” the report notes of the 2013 ophthalmology mistake.

Havering's MPs divided: Andrew Rosindell (L, Tory) and Jon Cruddas (R, Labour) blamed each other's parties for the trust's positionHavering's MPs divided: Andrew Rosindell (L, Tory) and Jon Cruddas (R, Labour) blamed each other's parties for the trust's position

But by its most recent visit, in October, it found: “To reduce the risk of this happening again, patients were not draped in surgical gowns until final checks had been completed, including checking the person’s consent form.”

Perennial problems that continue haunt the Rom Valley Way hospital include patients piling up in the A&E department.

A&E is “at times unsafe”, the report adds, because of a lack of full-time consultant and middle-grade doctors. “The longstanding problem of waiting times in the A&E department at Queen’s Hospital has not been addressed.”

On one occasion, inspectors found a patient who had been in the emergency department for 18 hours. They also found the average waiting time between referral from A&E to a specialist and actually seeing that specialist was 270 minutes – nine times the target of half an hour.

Elsewhere, nurses in the medical care department were unable to explain how to spot blood poisoning – which can be fatal.

“We asked staff how they would recognise sepsis and how they would respond to this,” the report said.

“None of the nurses we asked knew if a guideline was available to use or were able to clearly define what sepsis was.

“Some said they thought a sepsis care pathway was available on the intranet but none of them were able to locate it.”

The report concludes the hospital “must” complete a string of tasks, including the following:

• Cut A&E waiting times;

• Increase the number of permanent senior medics;

• Improve the management of blood poisoning;

• Improve the care in medical and surgical care services;

• Improve discharge and transfer processes;

• Improve the environment in the sexual health clinic;

• Improve documentation.

Havering’s MPs blamed each other’s parties for the trust’s sorry state.

Romford MP Andrew Rosindell praised efforts to bring about change at Queen’s – but blamed “crippling” PFI debt for dragging the trust down.

“This debt has a serious impact on the efforts of the trust management to turn around the quality of care at Queen’s Hospital and King George Hospital,” he said, “and I am disappointed that Romford residents are not receiving the level of care they are entitled to because of the serious error of judgement by [former health secretary] Andy Burnham in proliferating PFIs to over 200 hospitals.”

Jon Cruddas, MP for Dagenham and Rainham, said: “This recent CQC report, if nothing else, highlights the gaps that the government cuts have created locally.”

He added: “It was only a matter of time before the CQC stepped in and brought BHRUT under special measures.

“I have been campaigning for more investment in our health provisions since I became the local MP, but year after year our frontline services suffer more cuts. I will be meeting with the minister for health, Jeremy Hunt, and the heads of the Clinical Commissioning Group in both Havering and Barking and Dagenham at the nearest opportunity to see how best to proceed in these circumstances.”

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