South West London Urgent & Emergency Care Peer Review Visit – Report
A key element of the South West London 5 Year Strategic Plan is that urgent and emergency care (UEC) services across south west London work towards meeting our own minimum standards of quality by the end of 2016/17, to ensure that patients across south west London receive the same high quality care, no matter where they are treated.
These minimum standards are the London Quality Standards (LQS): evidence-based clinical standards that represent the quality of care that patients attending an emergency department, or admitted to hospital as an emergency, should expect to receive in every acute hospital in London[i].
They were developed by expert reference groups and through extensive consultation with clinicians from across London, drawing on best practice clinical guidance from institutions including Royal Colleges, government departments, and other professional groups and clinical bodies. The standards are supported by the London Clinical Senate and by all 32 London CCGs. They take into account the specific needs of patients in London and set a higher bar for clinical quality than is expected elsewhere in England.
To help achieve this aim, the four hospitals – Croydon Hospital, Kingston Hospital, St. George’s Hospital and St Helier Hospital – undertook a peer review of each other’s services including an assessment of how standards were being achieved as at November 2014. This included the first ever assessment of LQS covering the fractured neck of femur pathway, critical care, paediatric emergency medicine and general surgery, emergency departments and urgent care centres – all vital elements of UEC services.
All four acute hospital trust in SW London have made significant improvements in their achievement of LQS since the adult acute medicine and emergency general surgery standards were first assessed in 2012[ii]. The Peer Review process found that all of the hospitals are meeting the majority of the standards to varying degrees. The final assessment is binary (met or not met), however: to be recorded as ‘met’ a standard has to be fully met, 24 hours a day, seven days a week. Thus the report may not fully reflect improvements made and ‘not met’ should not be assumed to mean that the element is absent.
During 2015 this Peer Review assessment will be used by the hospitals as part of their joint work into how shared clinical models between the hospitals can help them to achieve the full range of LQS.