It took staff at North Middlesex A&E four-and-a-half hours to realise a patient was dead, with experts describing the safety of the department as “worrying”.
In February, the A&E department at North Middlesex University Hospital announced over a tannoy that patients should go home unless they were “dying”.
The news led to a surprise inspection by the health regulator the Care Quality Commission (CQC) in April.
Inspectors uncovered a series of failings, causing the unit to be rated “inadequate”.
Despite being one of the busiest departments in London, inspectors found there was no consultant present after 11pm, and vital equipment was often missing or broken.
Walk-in patients were initially assessed by a receptionist who chose whether to send them to the urgent care centre or emergency department.
There was a lack of training for junior doctors and nurses had to spend considerable time advising them. This had previously been detected by the General Medical Council (GMC), which issued preliminary warnings to hospital leaders for failing to train junior doctors.
22 serious incidents
There have been 22 serious incidents recorded at the unit in the last year alone, including one case in which a patient lay dead for over four hours before being found.
The report highlighted the absence of consultant-led care, stating: “Members of staff told us there was a culture of not calling consultants out at night. They said that middle grade doctors seemed to assume that it was acceptable to leave patients in ED (emergency department) overnight, thus treating it as if it were a hospital ward.”
Sir Mike Richards, the CQC’s chief inspector of hospitals, said patients “are entitled to a service that provides safe, effective, compassionate and high quality care. When we inspected we found that patients were waiting a long time to be seen, without being assessed by a doctor in the first place.”
He added: “It is worrying that we found that there were not enough experienced doctors on call to deal with demand. We have strongly encouraged the Trust to engage with other organisations across the local health and social care system to resolve these challenging issues.”
The hospital’s chief executive, Julie Lowe, is said to be on leave. However, one source said she had “secretly quit” following the report, with NHS chiefs criticising her leadership.
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