Enter and view: Queen's Hospital Emergency (A&E) Streaming and Urgent Treatment Centre

Healthwatch Havering conducted an Enter and View visit in December 2018 to the Streaming and Urgent Treatment Centre located in the Emergency Department (A&E) of Queen's Hospital, Romford. The Streaming System aims to relieve pressure on A&E by ensuring that only patients who have severe illnesses or injuries are referred to it and that others are dealt with more appropriately, either in the Urgent Treatment Centre that adjoins A&E, or by referral elsewhere to their GP, pharmacist or other healthcare professional.

A number of observations were made by the Enter and View representatives. These included that the signage directing patients to the Centre was inadequate as signs were often not visible and used the new term "Emergency Department" that the public are generally unfamiliar with. There were a number of patients awaiting test results and had been referred to the Urgent Treatment Centre, for which they were waiting up to 3 hours with patients overflowing into the corridors. There was no loudspeaker or electronic system for summoning patients which left them at risk of missing their place in the queue should they fail to hear the call. The team were also told that patients with intolerances/allergies together with Learning Disabilities/Dementia were not fully catered for as there were no visible signs of those conditions that could be dealt with in a primary care setting. Upon speaking to reception staff, the team were told that, although there is a small hearing loop sign within the waiting area, there was no equipment to provide such a system. There is no specific help for blind or partially sighted patients but they usually attend accompanied by a family member or friend.

Recommendations included that the signage in the waiting area, for queues and directions to treatment areas need to improved. A number queue control system could be used and staff should call the number reference rather than "next please." Additional waiting areas need to be made available to help with the number of patients waiting to be seen and staff should be confident in responding appropriately to those patients who are vulnerable, such as those with Learning Disabilities and recognising Hospital Passports.

The service provider (Partnership of East London Co-operatives) responded positively and has outlined a number of changes that have occurred as a result of the recommendations made by Healthwatch Havering.