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CQC shares practical examples to harness learning from COVID-19 in emergency departments

5 October 2020

In preparation for a difficult winter CQC shares practical examples from emergency department staff to help trusts harness the learning from coronavirus (COVID-19).

The Coronavirus pandemic led to different ways of working within hospital Emergency Departments (EDs) and fewer attendances gave staff greater flexibility to ensure effective social distancing and robust infection control. With ED attendances now rising, balancing that increased demand alongside continued COVID-19 care will bring significant challenge - particularly as we head into winter, with the additional risk that subsequent spikes of the virus may coincide with seasonal flu, creating even greater problems.

CQC has worked with a group of frontline clinicians from good and outstanding EDs across the country to better understand what lessons can be learnt from the impact of the pandemic and what good practice can be harnessed to support long term service improvements.

Published today (Monday 5 October) Patient FIRST, is an online resource aimed at helping ED staff, hospital trusts and the wider system to build on the positive changes brought in during the peak of the pandemic. Produced in partnership with clinicians, it presents practical examples that hospitals can apply now in their preparations for the winter ahead and is a valuable quality assurance tool for trust leaders.

The resource focuses on five key areas; Flow, Infection control, Reduced ED attendances, Staffing and Treatment (FIRST). It suggests actions that can be taken at a departmental, trust and wider system level to maximise capacity, maintain effective patient flow and keep staff and patients safe.

Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said:

“Everyone involved in the management and oversight of emergency care services is only too aware that we are heading into what is likely to be a very difficult winter, and should be looking at what they can do now to prioritise safety and keep patients and staff safe.

“Patient FIRST is a resource to help monitor safety - and identify what additional work may be needed to maintain it. For NHS trust boards in particular, it is an important reference for their assurance of the quality of emergency services and I encourage them to use it as such.

“But its use goes beyond the ED. We know from our inspections and our work with clinicians that the importance of hospital departments and local services working in a joined-up way cannot be underestimated.

“COVID-19 hit the UK as the NHS was emerging from a challenging winter during which hospitals grappled with heightened demand and continued workforce pressures. The pandemic has demonstrated the overwhelming resilience and commitment of staff working throughout health and social care. It has also laid bare the true interdependency of health and care – and, as highlighted in some of the examples published today - the benefit of services working together to support patient need.

“We must do everything we can to enable staff to continue in their efforts towards greater collaboration, both within hospitals and between hospitals and services in the wider community, if we are to avoid returning to a scenario where overcrowded emergency departments and corridor care becomes an increasing occurrence.”

Patient FIRST draws on the experience of frontline clinical staff and the findings from CQC’s inspections and monitoring of urgent and emergency care services. It highlights approaches CQC has seen adopted by good and outstanding EDs and includes a range of ideas to support safe, high quality care. These include suggested ways to increase clinical expertise at the “front door” and improve access to face-to-face specialists, as well as examples of effective working between hospital departments and between hospitals, primary care and community services that can help increase capacity, allow adequate social distancing and support patients to access the service most appropriate to their need.


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Last updated:
05 October 2020

Notes to editors

1. CQC’s Patient FIRST resource is available at

2. This work builds on the practical solutions presented in CQC’s “Under Pressure: safely managing increased demand in emergency departments” report which was published in 2018.

3. CQC’s current work with ED clinicians during the COVID-19 pandemic has informed blog posts from Professor Ted Baker, Chief Inspector of Hospitals and Heidi Smoult, Deputy Chief Inspector of Hospitals.

4. CQC is producing a podcast mini-series looking at emergency care through the lens of coronavirus. We’ll talk about what the challenges have been; share learning and innovation; and hear from clinicians who have been on the front line. The first of these podcasts will be available later this month on Soundcloud or your usual podcast provider.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.