Essex hospital declares major incident caused by “unprecedented demand” on emergency service

BMJ 2014; 349 doi: (Published 17 November 2014) Cite this as: BMJ 2014;349:g6891
  1. Zosia Kmietowicz
  1. 1The BMJ

A major incident was declared at Colchester General Hospital on 13 November after “unprecedented demand” from emergency department admissions and concerns about the way some patients were being treated.

The emergency assessment unit at the hospital in northeast Essex has been closed to new patients and an emergency control centre set up to deal with problems concerning capacity. Patients have been urged to use the hospital’s emergency department only if they have a serious or life threatening condition.

Concerns at the hospital led inspectors from the Care and Quality Commission (CQC) to make an unannounced inspection of its emergency department and assessment unit on 12 November. The report of the inspection has not yet been published, but senior managers at the hospital admitted that inspectors had raised concerns over safeguarding issues as well as the problems in the emergency service. The Guardian newspaper reported that patients were being inappropriately restrained, sedated without consent, and resuscitated when they had asked not to be.1

Lucy Moore, chief executive of Colchester Hospital University NHS Foundation Trust, which runs the hospital, told staff that “the trust declared an internal major incident because of the extreme pressures we are experiencing and the lack of capacity.

“A high number of escalation beds are in use and we are, unfortunately, having to postpone some elective operations. Clearly, this is a difficult time for the trust.”

Peter Wilson, the trust’s acting chairman, told the Guardian, “We are facing unprecedented demand at the front end and have declared today a major incident, which means a whole-hospital review of demand, capacity, staffing levels, and discharge processes and other opportunities for improvement. We have established a control centre under the command of the chief operating officer.”

The hospital was put into special measures in November 2013 after the health regulator Monitor found it to be in breach of its licence to provide health services.2 Earlier in 2013 the CQC had found evidence that figures on waiting times for cancer treatment at the hospital had been tampered with to make it appear that some patients were treated earlier than they had been.3 Police are investigating what happened.

A CQC inspection this summer rated the hospital overall as “requiring improvement” and “inadequate” in terms of leadership. It was also identified as an outlier in terms of patient mortality by the Health and Social Care Information Centre in the two years from July 2011 to June 2013.4

Responding to the claims of safeguarding problems put to the hospital by the Guardian, Moore said, “The Care Quality Commission raised a small number of safeguarding concerns when its team gave immediate feedback at the end of the inspection on Wednesday.

“The trust takes safeguarding extremely seriously and is now investigating to find out whether our policies had been followed appropriately.”

Mike Richards, the CQC’s chief inspector of hospitals, said, “CQC carried out an unannounced inspection at Colchester Hospital this week in response to concerns. The inspection looked at the accident and emergency department and the emergency assessment unit.

“Following the inspection, we gave feedback to the trust about our safeguarding concerns so that it could take appropriate action to ensure the safety and wellbeing of its patients.

“We will return to carry out further inspections at the trust, and we are working urgently with Monitor to resolve these issues. A full report of CQC’s findings will be published on our website in due course.”


Cite this as: BMJ 2014;349:g6891


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