A study by Healthwatch Enfield has "found no evidence" that the closure of the A&E service at Chase Farm Hospital has had an adverse effect on Enfield residents being able to access emergency services. The authors of the study report also conclude that the Urgent Care Centre at Chase Farm has been coping well with unexpectedly high numbers of attendees. However, they acknowledge that the A&E service at the North Middlesex Hospital has not been performing well, but, pointing out that this was already the case before Chase Farm A&E closed, do not find evidence that the closure has exacerbated the situation at the North Mid.
The report, entitled Attendance and performance at A&E departments serving Enfield residents since the closure of Chase Farm Hospital A&E, can be downloaded from the Healthwatch Enfield website. The website also has an introductory page, which includes the bullet point summary shown in the box below.
- As expected, there has been a rise in attendances at both North Middlesex University Hospital A&E and Barnet Hospital A&E. However, the data suggests that attendance has not increased to the high levels originally predicted
- Waiting times at Barnet Hospital have improved since the closure of Chase Farm A&E
- Chase Farm Urgent Care Centre is seeing an increasing number of patients (up to 900 a week at the busiest time) and consistently seeing them within a 2 hour time target
- North Middlesex University Hospital A&E were not always reaching their waiting time targets before the closure of Chase Farm A&E. Since then their performance has been below target, more often than above. Given that attendances have not reached the levels predicted, it is unlikely that any drop in performance is directly related to closure of A&E at Chase Farm.
- Although it has been difficult to make conclusive interpretations from published data due to the reasons outlined in the report, the report finds no evidence that the Clinical Strategy has had an adverse effect on Enfield residents being able to access emergency services.
The closure of Chase Farm A&E in December 2013 was a major element of the Barnet, Enfield and Haringey Clinical Strategy. The A&E unit was replaced by an Urgent Care Centre, Older People’s Assessment Unit and Paediatric Assessment Unit. To compensate A&E provision at both Barnet Hospital and the North Mid was increased.
These changes were, and remain, controversial (to put it mildly). Unfortunately, the Healthwatch report is unlikely to put an end to the arguments around Chase Farm, as the authors' conclusions are significantly qualified. In addition to the normal problems with assessing the effectiveness of health service provision resulting from unpredictable variations in demand (whether hour-to-hour, day-to-day, or over longer periods), there were gaps in the data provided by the three hospitals and used to make the assessment.
An important part of the "Clinical Strategy" was supposed to be improvements to provision of primary care (eg GP surgeries) to compensate for any reduction in hospital capacity. The report mentions that Healthwatch Enfield is monitoring primary care services but does not include any assessment of whether or not the promised extra primary care services were ever put in place. In late 2013 this was a key issue associated with the unsuccessful legal action taken by Enfield Council in a bid to postpone the Chase Farm changes.