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10 July 2013, 05:38
The health regulator's found Queen's Hospital in Romford is still failing emergency patients, almost two years after it called for improvments.
The Care Quality Commission (CQC) has told Barking, Havering and Redbridge University Hospitals NHS Trust that it must make urgent improvements to the emergency department there.
The fresh warning comes after concerns were first raised in July 2011.
During their most recent visit in May, inspectors found that patients who arrived at the hospital by emergency ambulance were waiting too long to be assessed.
During April, one in 20 people were waiting 45 minutes, even though patients should be seen in 15 minutes.
On occasions, bed shortages meant patients were forced to wait up to 14 hours before being admitted to hospital, the report found.
Matthew Trainer, regional director of CQC in London, said: "The emergency department at Queen's Hospital in Romford is failing local people.
"This situation has been going on for far too long. Radical thinking is needed, led by the Trust Development Authority and commissioners.
"The trust's board needs to work with them to make sure patients get the care they deserve.
"Patients are entitled to be treated in services which are safe, effective, caring, well run, and responsive to their needs. We have seen several recovery plans come and go in the emergency department at Queen's and there is little evidence of any impact.''
In the first four months of the year, there were multiple occasions where ambulances had to be diverted away from Queen's to other hospitals in London, the CQC said.
Some patients waited more than an hour between arriving in an ambulance and being handed over to a doctor.
The report found that the trust has not had enough permanent consultants or middle-grade doctors for several years.
At the time of the inspection, the average waiting time for consultations with a specialist was more than three hours, even though the trust's own policy is that all patients should be seen by a specialist doctor within 30 minutes.
"The fundamental problems we first raised in 2011 - not enough doctors in the emergency department, and unacceptable delays in getting specialists from elsewhere in the hospital to see people admitted through A&E - are still there,'' Mr Trainer said.
"This means excessive waits and ambulances being diverted to other hospitals.
"The staff who work there told us they feel under siege despite their best efforts to deliver good care.''
Inspectors found that, while people were still spending far too long in the emergency department, there had been some improvements in the availability of food and drink and delivery of personal care.
Averil Dongworth, the trust's chief executive, said she recognised that waiting times were still too long. "While I am pleased that it acknowledged that improvements have been made with personal care and the way we look after patients, this does not address the larger issues of waiting times and staffing,'' she added.
"We have been working tirelessly to improve the situation so that we can provide our patients with the best possible care.
"We will be working with NHS partners, including the Clinical Commissioning Groups and London Ambulance Service, to address the long-standing causes behind the demand on our services and our poor performance in responding to it.''
She added that the trust receives about 110 ambulances each day, more than any other London hospital and almost 15% more than a year ago.
New appointments have been made to increase the number of high-quality, permanent doctors in the emergency department.