© PA North Middlesex Hospital One of London's busiest hospitals has apologised after a report called its A&E services "inadequate", with a patient lying dead for several hours before being noticed.
The revelation about North Middlesex University Hospital's urgent and emergency care services came in a report from Care Quality Commission (CQC) inspectors which rated services as "inadequate" and found there were not enough doctors to cope with demand.
Hospital staff told inspectors they had concerns about middle-grade doctors who were often left in charge of A&E overnight with no consultants in the department after 11pm.
In some cases, patients had to wait until morning to find out if they were to be admitted or sent home because doctors on duty would not make an immediate decision, the report said.
"Members of staff told us there was a culture of not calling consultants out at night," said the CQC.
"They said that middle-grade doctors seemed to assume that it was acceptable to leave patients in ED (emergency department) overnight, thus treating it as if it were a hospital ward," the report adds.
Meanwhile, nurses told inspectors they spent a "substantial amount of time supporting and advising more junior doctors".
North Middlesex University Hospital medical director Dr Cathy Cale said: "We are extremely sorry for the current problems in A&E and for the long waiting times for some patients.
"We are committed to getting back to the standards that we and our patients expect and, working with our health partners, are taking all the necessary steps to address the concerns raised, particularly the shortage of doctors which lies at the heart of it."
Sir Mike Richards, CQC chief inspector of hospitals, said: "North Middlesex University Hospital is one of the busiest A&E departments in London - so it is worrying that we found that there were not enough experienced doctors on call to deal with demand.
"We have strongly encouraged the trust to engage with other organisations across the local health and social care system to resolve this challenging issue.
"The evidence from our latest inspection last week is that North Middlesex's emergency department has turned a corner, but there is still much more that needs to be done. We will be watching their progress very closely."
It has been revealed that the General Medical Council has issued preliminary warnings to the hospital's leaders about the lack of training for junior doctors with a threat of "withdrawal of approval for the trainees in the emergency department".
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