Table 1

Selected extracts from CQC inspection reports that refer to performance on the NHS England indicators

HospitalExtract from report narrative
Trust rating: outstanding
  • The department exceeded the target of 95% of all patients to be admitted, transferred or discharged within 4 hours of arrival to the ED every month. The trust had been meeting this target annually since February 2012 and was one of the top five performing trusts in the country

  • The proportion of patients leaving before being seen was lower than the England average

  • The unplanned re-attendance rate to the ED within 7 days of discharge ranged between 5% and 7%. This was consistently lower than the England average of above 7% but higher than the national standard of 5%

Trust rating: good
  • Since July 2015, the department had met the national 4-hour waiting time target and most patients were discharged within 3 hours of attendance. The trust was performing better than the England average for a number of other performance measures relating to the flow of patients

  • Between June 2015 and September 2015, the trust rate for unplanned re-attendance at A&E within 7 days was 0.3% (better than the England average)

  • Only 3.2% of patients left the department before a clinician saw them. This was significantly better than the 5% standard set by the trust

Trust rating: requires improvement
  • The trust performed mostly above the 95% standard for percentage of patients waiting to be seen within 4 hours since May 2014, with the exception of December 2014 and May 2015. This was an improvement in the previous years

  • The latest available information showed that the unplanned re-attendance rate for September 2014 was 2.2%, while in August it was 2.5%, and 2.7% in July

  • The number of patients leaving without being seen was higher than the national average. In March 2015, this was 2%, while in February, it was 1.8%, and in January, 2%. This was the latest available information

Trust rating: inadequate
  • National standards of being admitted, transferred or discharged within 4 hours had not been met since October 2014. The processes put in place to trigger action to deal with poor flow through the EDwere delayed and slow, and patients frequently and consistently could not access the hospital in a timely way, experiencing unacceptable waits

  • The rates of unplanned re-attendance for the trust were lower than the national average for most of 2013 to 2015 but were higher for February 2015. We asked what had been identified as the reason for the increase but the management of the ED could not offer any specific reason and the increase had not been investigated

  • The percentage of patients leaving before being seen was higher than the national average for most of January 2013 to October 2015

  • CQC, Care Quality Commission; NHS, National Health Service.