Our on-going improvement, as part of our integrated healthcare system in north east London, has been recognised following a progress review by NHS England.
The review was part of a national plan – introduced a year ago this week – to recover urgent and emergency care, in which healthcare systems were placed into tiers 1-3 depending on the level of support required to improve. NHS North East London was initially placed in tier 1, requiring the highest level of support and monitoring. Following the review, we no longer need such intense help and are the only system to be moved from tier 1 to tier 2.
This was thanks to our progress, and that of our partners, on the targets set over the last year, including seeing patients more quickly in our emergency departments and urgent treatment centres (UTCs).
In 2023, we were the most improved trust in England for our performance against the national target for those who are most seriously ill (Type 1), going from 32 per cent in January to 50 per cent in December. Last month, nearly 5,000 more patients (of the 28,000 who attended) were seen and treated in our A&Es and UTCs within four hours compared with the previous December. This has seen us rise from one of the worst performing trusts to the top 25 per cent in England.
We’re also on track to hit the 76% recovery target for overall performance with the help of PELC, a GP cooperative which runs the UTCs where the less seriously ill (Type 3) patients are seen. They’ve benefitted from additional investment from the north east London Integrated Care Board (ICB); they’ve increased the number of doctors at both sites; and Queen’s atrium no longer has long queues of sick patients since we moved the hospital’s UTC entrance.
We’ve worked closely with the London Ambulance Service to help paramedics to get to patients quicker by reducing handover delays in our A&Es. At King George Hospital, we reduced handovers taking over an hour, they now account for just one per cent of all handovers, against a national average of 13 per cent. We also reduced the average handover time by 23 minutes.
In a letter confirming NHS North East London’s move from tier 1 to tier 2, Sarah-Jane Marsh, Director of Integrated Urgent and Emergency Care, said: “This reflects the sustained improvement in performance and the progress towards achieving targets, together with your clear commitment to culture change and empowering your frontline clinical and operational leaders.”
Zina Etheridge, Chief Executive of North East London ICS, said: “I am proud of this recognition of the hard work of local clinicians and partners to improve the care and experience of local people when they need urgent and emergency care.
“We are the only healthcare system to move from tier 1 to tier 2, and the commitment and efforts of the teams at BHRUT have been at the heart of this improvement. Their work with PELC, who run our urgent treatment centres in Havering and Redbridge, has shown how collaborative system working makes a positive difference to local people.”
Matthew Trainer, our Chief Executive, said: “It’s great news our improvement has been recognised. We have a long way to go, and some people are still waiting far too long in our A&Es. But the progress made so far is down to the hard work of our staff, helping us to cut waits and provide better care for our patients.
“Thanks to our local partners and colleagues at NHS England for their support. We’ve found Tier 1 a useful process. It has helped us focus on where we can make the most difference for patients, and we’ve benefitted from the leadership and expertise of the national team.”
Our improvement has also seen the CQC raise the rating for urgent and emergency care at both our hospitals from inadequate to requires improvement.