Archived: Ealing Hospital Accident & Emergency Department

Updated 17 May 2017

Ealing Hospital Accident and Emergency Department (Ealing Urgent Care Centre) is a GP led urgent care centre based at Ealing Hospital, immediately next door to the Accident and Emergency Department. It is the first point of contact for all ambulatory patients and those brought in by ambulance with the exception of those who need to go straight to the emergency department as per referral criteria. They treat minor illnesses and injuries that require urgent and immediate attention . The aim of the centre is to take pressure off the emergency department. The centre is open 24 hours a day, every day: it does not close for bank holidays or at weekends.

It is a GP led centre with nurses providing triage after patients register with reception staff. The centre is led by five full time GPs, five emergency nurse practitioners, three full time health care assistants, 10 reception and one managerial staff. There are a further five GP and six emergency nurse practitioner posts which are vacant. The centre is available to all people with an urgent health need 24 hours a day 365 days a year. They see approximately 5,000 patients each month. The urgent care centre is managed by Care UK Clinical Services Limited on behalf of the Ealing Clinical Commissioning Group. The provider operates the urgent care centre from one location, they are registered to provide the regulated activity of treatment of disease, disorder or injury. This inspection focused on the urgent care centre.

The centre had a manager although they had not registered with CQC at the time of the inspection.

The centre shares its reception with the hospital emergency department with clear signage to direct patients to the area they need, we saw reception staff directed patients to other areas when required. They have a small paediatric waiting area and a larger general waiting area. The centre has seven consultation rooms and one treatment room, a clean and a dirty utility room and an office.

We previously inspected the service in June 2012; the five areas inspected were meeting the standards in place at that time.

Updated 17 May 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ealing Hospital Accident and Emergency Department (Ealing Urgent Care Centre) on 20 October 2015. The provider operates an out of hours service from the same location which was not inspected during this visit. The provider is no longer providing this service.

Our key findings were as follows:

• Patients said their privacy and dignity was maintained, staff spoke with them in appropriate ways and they were involved in decisions about their care and treatment.

• There were systems in place for reporting and recording significant events. However, there was limited evidence to show lessons learned were shared to make sure action was taken to improve safety in the centre.

• The provider had systems in place for when there were unintended or unexpected safety incidents which included patients being provided with reasonable support, truthful information, a verbal and written apology. Patients were told about any actions to improve processes to prevent the same thing happening again.

• The centre had clearly defined and embedded systems, processes and practices in place to keep patients safe and safeguarded from abuse.

• Suitable arrangements were in place for infection control, although there was no process to review the cleaning.

• Although risks to patients were assessed, the systems and processes to address these risks were not always implemented well enough to ensure patients were kept safe. For example in relation to medicines management and calibration of equipment.

• Systems were in place to ensure clinical staff were up to date with both National Institute for Health and Care Excellence (NICE) guidelines and local guidelines. Staff assessed needs and delivered care in line with current evidence based guidance.

• Audits were used to ensure quality improvement.

• Staff had the skills, knowledge and experience to deliver effective care and treatment, new staff completed an induction, all staff had access to required training and all staff received an annual appraisal.

• The provider had an understanding of the performance of the service and used a range of monitoring information to ensure levels of care and treatment were appropriate.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice