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

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Summary of report content

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.

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General details

Report title 
Enter and view: Queen's Hospital Emergency (A&E) Streaming and Urgent Treatment Centre
Local Healthwatch 
Healthwatch Havering
Date of publication 
Tuesday, 26 March, 2019
Date evidence capture began 
Wednesday, 5 December, 2018
Date evidence capture finished 
Wednesday, 5 December, 2018
Type of report 
Enter and view
Key themes 
Cleanliness hygiene and infection control
Communication between staff and patients
Information providing
Staff levels
Waiting time to be seen once arrived at appointment
Healthwatch reference number 

Methodology and approach

Was the work undertaken at the request of another organisation? 
Primary research method used 
How was the information collected? 
Visit to provider
If an Enter and View methodology was applied, was the visit announced or unannounced? 
Not Known

Details of health and care services included in the report

Urgent and emergency care services 
Accident & emergency
Urgent care services

Details of people who shared their views

Number of people who shared their views 
Age group 
Specific ethnicity if known 
Sexual orientation 
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 
All care professionals
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 action has been taken or promised
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
What type of impact was determined? 
Tangible Impact (cost related)

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.