New NHS trust boss blames A&E waiting times on pressure faced by whole system

The new chief executive of the trust behind King George and Queen’s Hospitals insists they have the worst A&E wait times in the country because too many people cannot access local services.

Last month, Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) treated less than three in ten of its most urgent cases within four hours.

Local politicians have described BHRUT’s A&E waits as “abysmal” and begged the trust’s new chief executive Matthew Trainer to improve them.

Trainer, the trust’s first permanent chief executive in at least five years, told Redbridge’s health scrutiny committee last week that the “whole system” is under pressure.

Referring to a recently published inspection of Queen’s emergency care, he said: “They praised the team and the leadership for their dedication to making the emergency pathway work as well as possible.

“The [Care Quality Commission] didn’t change our rating or give us ‘must-dos’, they inspected the whole system, and it’s clear… there are far too many people using both sites because they can’t get access to local services.”

He added that a recent independent survey of 460 patients found a “significant number” needed treatment for health problems that Queen’s Hospital “wasn’t designed for”.

Reasons given for BHRUT’s poor waiting time performance include a lack of staff to open more beds, a lack of capacity in care homes for elderly hospital patients and a “revolving door” of chief executives in recent years.

East London health bosses have also admitted underfunding in GP services and community health over the last decade is a key cause of high pressures on BHRUT.

During an unannounced inspection in November last year, the Care Quality Commission found “overcrowding, compromised infection control and extended waits” linked to a shortage of GP services.

Inspectors called for better collaboration between the “complex” parts of the health and care system.

The report said: “We were told there were capacity issues, especially in primary care, resulting in delays for patients trying to access urgent care or patients being signposted from 111 to acute services.

“We were told appointments for out of hours GPs were often unavailable. This put additional demand on the hospital and caused further delays in patients accessing treatment.”

Recently published figures show that north east London has one of the lowest GP to patient ratios in London, partly due to a “national shortage”.

Commissioners of frontline GP services, North East London Care Commissioning Group (NEL CCG) have published plans admitting there has been a “historic and chronic under-investment”, with a “lack of focus” on early invention.

A spokesperson for NEL CCG said: “Given the immense challenges presented by the pandemic and its impact on urgent and emergency care, we are pleased the CQC has acknowledged [BHRUT’s] ongoing work to manage demand and improve access to services.

“However, we accept that we still have work to do in a number of areas and partners across the health and care system are committed to working together in an integrated way to address the issues raised by inspectors.

“Our priority is ensuring patients have access to safe and high quality services wherever they live.”

Josh Mellor

Local Democracy Reporter