Optimistic Queen’s hospital improvement.

In recent years Queen’s Hospital in Romford and King George Hospital in Goodmayes, which are both run by the same trust, BHRUT, have had the longest emergency department waiting times in England.

Local Democracy reporter Josh Mellor today writes:

An East London hospital boss says he feels “cautiously optimistic” after seeing A&E waiting times improve since he took the helm two and a half years ago.

In recent years Queen’s Hospital in Romford and King George Hospital in Goodmayes, which are both run by the same trust, BHRUT, have had the longest emergency department waiting times in England.

When chief executive Matthew Trainer took over, Barking, Havering and Redbridge University Hospitals Trust (BHRUT) was reeling from the impact of the pandemic and had suffered a “revolving door” of chief executives in the previous decade.

A key measure of the trust’s performance – how many patients with urgent conditions were discharged, admitted or transferred within four hours – was at only 35%, the worst in England.

The trust’s four hour performance is now up to about 50%. Although this is still the 44th worst it is significantly better than neighbouring East London trust Barts Health and several other London hospital trusts.

Speaking to the Local Democracy Reporting Service, Trainer said he feels “cautiously optimistic” about BHRUT but accepted that “too many” patients would still say they waited too long.

He added: “It does feel different now, I’ve been here for two years and I would say the organisation feels calmer.

“When I joined you could really feel the after effect of the pandemic, services had been really disrupted, lots of short-term moves had been made and we had to spend a lot of time unpicking them.”

A key step in improving the trust was hiring new permanent senior staff such as chief operating officer Fiona Wheeler and Mamta Shetty Vaidya as chief medical officer.

Trainer said the trust has also carried out “really detailed work”, much of which will be “quite slow” before it shows improvements.

However, he has also contended with regular doctors’ strikes and large waiting lists after the pandemic.

The trust faces a host of other local issues including low numbers of GPs serving residents in outer East London and a shortage of beds for mental health patients, who face long waits at BHRUT hospitals.

In regular public “stakeholder updates”, Trainer, a former journalist, has sometimes raised concerns about the effect of these challenges, which are often out of his control, on his hospitals.

Another key aspect to the trust’s improvement is waiting times for its type three emergency care, for patients with less serious or urgent illnesses or injuries.

Although type three care is provided at Queen’s and King George Hospitals, it is sub-contracted out to a “GP cooperative” called Partnership of East London Co-operatives (PELC).

Until August this year PELC’s four-hour performance was at 70%, the lowest in the country.

In early 2023, health inspectors rated PELC’s service as inadequate and ordered it to improve on low-staffing levels, unsafe assessment waiting times and poor leadership.

Trainer said PELC’s performance has now jumped to 94%, partly thanks to NHS North East London putting “millions more” into its contract.

Queen’s and King George continue to see increasing numbers of patients in their emergency departments – 28,800 in January – meaning they struggle to keep up with demand.

Trainer said: “When Queen’s was built it was for 300 emergency department patients per day – that was the working assumption.

“Now we’ve got 600, it’s got so that we can’t physically keep up with the pace of the demand.”

Looking to the future, Trainer said he wants to see more large investments into the hospitals, on top of the £56million recently confirmed for its first electronic patient record system, and £12m on a new hospital-wide Wifi and digital upgrade.

A new Health and Wellbeing Hub at the former St George’s Hospital site in Hornchurch will also host BHRUT’s renal and frailty services.

Trainer said Queen’s now needs further investment to provide “modern healthcare” in its emergency department, using space created by moving services to St George’s.

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