Enter and view: Emergency Department Royal Free Hospital, Barnet

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Summary of report content

Healthwatch Barnet and Healthwatch Camden conducted an announced Enter and View visit to the Emergency Department in the Royal Free Hospital. The visit aimed to evaluate access for those with communication impairments to emergency departments. The team engaged with staff members, service users and observed the working practice. The visit highlighted a lack of policy and procedure for supporting patients with sensory impairments. The team observed that the reception area was poorly lit and information displayed was not printed clearly. They also observed that signage across the hospital was not clear. The provider does not have an in-house communications team but reported that they had access to an interpreter within the hour of requesting one. There was some concern about patients whose first language is not English who require access to a BSL interpreter as there is no formal procedure for such cases. Staff reported that as they did not have a communications toolkit available in reception, they would rely on using the internet. There was access to large print information for patients when required. Staff reported that they received training several years prior but there is no formal deaf/disability training. It was noted that patients who require support usually bring their carers or relatives with them. The report made 7 recommendations to the provider. These included improved monitoring of patients who attend with sensory impairments, to provide visual and hearing impairment training to all staff members annually, to provide a communications handbook for reception staff, consider the use of video interpreting, to reduce the reliance on carers and relatives as informal interpreters, for the hospital to develop policies and procedures for supporting people with sensory impairments and for a pager system to be implemented in reception for patients presenting at A&E with sensory impairments. The service provider responded to the report and recommendations stating that they will consider implementing some of the recommendations and disagreeing with others.

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General details

Report title 
Enter and view: Emergency Department Royal Free Hospital, Barnet
Local Healthwatch 
Healthwatch Barnet
Healthwatch Camden
Date of publication 
Friday, 29 April, 2016
Date evidence capture began 
Monday, 14 March, 2016
Date evidence capture finished 
Monday, 14 March, 2016
Type of report 
Enter and view
Key themes 
Building and facilities
Communication between staff and patients
Consent to care and treatment
Health inequalities
Information providing
Patient records
Service delivery organisation and staffing
Healthwatch reference number 

Methodology and approach

Was the work undertaken at the request of another organisation? 
Primary research method used 
Structured interview
How was the information collected? 
Visit to provider
If an Enter and View methodology was applied, was the visit announced or unannounced? 

Details of health and care services included in the report

Urgent and emergency care services 
Accident & emergency

Details about conditions and diseases

Conditions or diseases 
Eye conditions
Types of disabilities 
Learning or understanding or concentrating
Vision impairment
Types of long term conditions 
Blindness or severe visual impairment
Deafness or severe hearing impairment

Details of people who shared their views

Number of people who shared their views 
Age group 
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
Types of health and care professionals engaged 
Service manager
Does the information include other people's views? 
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Yes but provider disagrees
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
What type of impact was determined? 
Implied Impact

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.