Enter and view: Queen's Hospital Emergency Department Streaming and Urgent Treatment Centre

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Summary of report content

On Wednesday 5th December 2018, Healthwatch Havering conducted an enter and view visit in the A&E Department Streaming and Urgent Treatment Centre of Queen's Hospital. The Centre is the first point of contact between most patients and A&E. Patients are assessed there and staff decide whether they need to be referred to other services. Healthwatch Havering assessed the Centre using the main themes of signage, streaming and staffing. They found that the Streaming system is working to patients' advantage, ensuring that people receive the most appropriate treatment to their needs. However, improvements to signage, the small waiting room, and streamlining the Streaming and treatment process is needed. Therefore, the recommendations are as followed: to improve the signage in the department, to consider the provision of a simple number queue control system with a display screen showing the number and informing patients who is next, to provide separate waiting areas for those who are arriving and awaiting Streaming and for those who have been Streamed and are awaiting treatment, to call patients forward for streaming other than calling "next please", and to train staff to be confident in responding appropriately to those patients who are vulnerable. The service response to this report told us they had ordered new improved signage, introduced the OPEL escalation plan for when queues are long, equipped a third streaming room, implemented electronic streaming, ordered an electronic ticket machine, installed electronic feedback kiosks, and developed a joint major incident plan.

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General details

Report title 
Enter and view: Queen's Hospital Emergency Department Streaming and Urgent Treatment Centre
Local Healthwatch 
Healthwatch Havering
Date of publication 
Wednesday, 5 December, 2018
Date evidence capture began 
Wednesday, 5 December, 2018
Date evidence capture finished 
Wednesday, 5 December, 2018
Type of report 
Enter and view
Key themes 
Building and facilities
Cleanliness hygiene and infection control
Communication between staff and patients
Complaints procedure
Consent to care and treatment
Continuity of care
Digitalisation of services
Holistic support
Information providing
Integration of services
Quality of care
Quality of staffing
Service delivery organisation and staffing
Staff attitudes
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? 
What type of organisation requested the work 
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? 

Details of health and care services included in the report

Primary care services 
Urgent care services
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 
Not known
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Not known
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 action has been taken or promised
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
Not known
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.