A health watchdog rated a hospital’s accident and emergency unit as ‘requires improvement’ - just as it had a boom in patients.

North Middlesex University Hospital, in Sterling Way, Edmonton, was criticised by the Care Quality Commission in its latest inspection.

In a summary of its decisions, the CQC stated that the A&E unit, which recently underwent a makeover to cope with the strain of Chase Farm Hospital’s A&E closing, has an “over-reliance from the people living in the local community".

The report read: “This had an impact on the numbers of people attending and the pressure on the department. Patients at risk of deteriorating were not always identified early, which may lead to poorer outcomes.”

Other services branded as requiring improvement include the medical care, end of life care and outpatient services.

CQC’s chief inspector of hospitals, Professor Sir Mike Richards, said: “When we inspected North Middlesex University Hospital we saw that demand for services had increased, due largely to the closure of A&E at Chase Farm Hospital. Staff were working hard to meet this increased demand, but more needed to be done by the trust to make sure good quality care was maintained.

“Across the hospital, we saw staff delivering compassionate care. This is something of which the trust should be proud. But there is still more to do here to make sure that people receive the best possible care across the board.”

A total of 24 of the 38 categories inspected at the hospital were rated as ‘good’, including surgery, critical care, maternity and children’s care.

The trust was not judged unsafe when inspected, despite safety being included in the 'requires improvement' category.

The CQC has made a number of suggestions to improve services at the hospital:

• The outpatients department should be responsive to the needs of patients, ensuring that appointments are made in a timely manner, those with urgent care needs are seen within the target times, cancellations are minimised and complaints are responded to.

• Action is taken to improve training and the recording and administration of training records and requirements.

• Partnership working with local primary care providers to enable the most appropriate use of primary care services by the local population.

The hospital's chief executive Julie Lowe said: “We welcome the news that we are close to achieving the rating of ‘good’.

“We have been through a period of massive change, with 450 new members of staff, the building of a new maternity unit and the refurbishment of six acute medical wards, all within six months of the new style CQC inspection. Our caring staff have worked tirelessly to provide great care for local people and to manage the enormous changes.

“We continue to provide safe, high quality services for local people that meet all national and London NHS quality standards and we are pleased that the CQC acknowledges this.” 

Deborah Fowler, chairman of watchdog Healthwatch Enfield, said: “The report has a lot of strong positives in it, with 60 per cent of the aspects rated by the CQC scored as ‘good’. We understand from the CQC that scoring good in any area is quite an achievement and that having some areas for improvement is to be expected.

“However, Healthwatch Enfield will of course be looking to see the recommended improvements made in performance as soon as possible and welcomes the fact that NMUH is already working on the areas of relative weakness identified by the CQC.”