East London hospitals’ urgent treatment centre waits ‘getting worse’

NHS England has set a target of 95 per cent of patients being admitted, transferred or discharged within four hours after arriving.

But at the centres at King George Hospital in Goodmayes and Queen’s Hospital in Romford, only 66pc of patients were dealt with in that time in June.

The urgent treatment centres – both rated inadequate by the Care Quality Commission last year – assess the health needs of any patient walking into the hospital and provide treatment for less serious conditions.

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They had the second worst four-hour performance out of more than 200 NHS urgent treatment services in England and are 16pc lower than the next worst-performing service.

Although the hospitals are run by Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT), the trust has no direct control over the company subcontracted to manage the centres – an organisation called Partnership of East London Co-operatives (PELC).

When contacted for comment, NHS North East London (NHS NEL), which oversees PELC’s service, said there has been “high levels of demand” from walk-in patients in recent months that has put extra pressure on the service.

The spokesperson told the Local Democracy Reporting Service (LDRS) that “extremely hot weather, high pollen levels and an air pollution alert” also led to a “marked increase” in people seeking medical help.

However, NHS statistics show that PELC’s performance at King George and Queen’s has been amongst the lowest in the country since June last year when the centres dealt with 81pc of patients within four hours.

Since then it has continued to decline and in January this year it became the worst performing in the country, dealing with only 77pc of patients within the target time – seven percent lower than the next worst NHS service.

Matthew Trainer, chief executive of King George and Queen’s hospitals, has also previously criticised the unusual model of PELC, an outside organisation, managing services in his hospitals.

BHRUT chief exec Matthew Trainer feels NHS NEL needs to think differently (Image: BHRUT)

He said the model “needs to change for patients” and he urged NHS NEL, which is responsible for PELC’s service, to “think differently”.

One reason for the long waiting times at the hospitals is thought to be linked to the number of GPs working in Redbridge and Havering.

Redbridge and Havering have an average of 2,074 patients per GP, higher than the English average of 1,700 and far higher than Hackney, which has only 1,270 patients per GP.

Havering also has a large elderly population that is much more likely to be hospitalised than in other parts of the city or country.

Chief executive of watchdog Healthwatch Havering, Ian Buckmaster, said his organisation is “acutely aware” of the number of local GPs being “below the level that anybody would like to see”.

He added: “There are a number of GPs who are approaching retirement, they’re not necessarily going to be replaced.

“Unless somebody comes along and is prepared to take it over the NHS NEL will have to find another practice nearby into which it can merge the patients.

“It is a perfect storm of problems. There seems to be reluctance on the part of doctors to become GPs.”

NHS NEL, which recognises that outer east London is “under-doctored,” did not respond directly when asked whether a lack of GPs is adding to pressure on hospitals.

However, a spokesperson said it has worked “exceptionally hard” to provide more appointments and has recruited around 380 staff such as nurses and pharmacists to support GPs.

Public understanding of how NHS NEL manages the commissioning of GP services also became more limited last year when it stopped publishing reports showing how it monitors and awards new contracts.

As well as high numbers of patients, PELC faces financial challenges. Its accounts for the year ending in March 2022 say it has a “material uncertainty” due to debts of about £2million.

In 2021 the Health Service Journal reported that PELC faced threats of criminal prosecution by the Financial Conduct Authority for failing to file its annual accounts between 2018 and 2020.

The now-published accounts show that after PELC’s service at King George was rated “inadequate” in 2018 it lost a contract managing 111 calls for the NHS.

PELC was then left with a large bill for a 3000sqft office in Ilford previously used by 300 call handlers and several senior managers left.

Despite these issues, local NHS commissioners awarded PELC with a five-year contract to provide urgent treatment centres at Queen’s Hospital, King George Hospital, Barking Community Hospital and Harold Wood Walk-in Centre.

At first PELC did not respond to requests for comment from the LDRS, however, later it issued a statement through a spokesperson at North of England Commissioning Support, acknowledging “delays for people accessing treatment”.

When asked whether it is employing less medical staff to pay off its debts, it responded only that 2021 financial issues have now been resolved.

The spokesperson added: “We are working closely with partners, including colleagues at Barking, Havering and Redbridge University Hospitals NHS Trust, to ease demand, reduce waiting times and ensure we provide better, more responsive care for patients.”