Check against delivery
Government targets say no more than 5% of patients should be waiting longer than 4 hours in accident and emergency departments. Yet, on Monday 14th January date in The Northern Echo, it was reported that the North East Ambulance Service
“has admitted that it is struggling to meet demand, after an elderly Parkinson’s Disease sufferer waited 11 hours before being taken to hospital.
North-East Ambulance Service NHS Trust bosses said a surge in winter-related call-outs meant it was having to prioritise patients.
The North East Ambulance service has apologised to 84-year-old Eileen Anderson, of Marton, Middlesbrough, after it emerged ambulances are queuing for hours at hospitals across the region before being able to hand over patients.”
Mrs Anderson is a constituent of mine and whilst this may be an extreme example of the delays that are occurring, unfortunately it is not an isolated incident.
Late last year the health care regulator, the Care Quality Commission (CQC), reported that 33% of people spent more than 4 hours in A&E. This was before winter, where research shows that the number of people waiting for A&E treatment in England has risen by 47,000. These waiting times are the worst in almost a decade.
The CQC has warned that 17 hospitals are understaffed and cannot guarantee patients safety. James Cook University Hospital, which serves many in my constituency, including Mrs Anderson, has said the delays in admitting patients are being caused by insufficient staff numbers and a lack of available beds. My most recent knowledge is that the hospital is holding weekly meetings with ambulance bosses in an attempt to alleviate delays. Whilst the Trusts should be praised for taking action, the fact that this is necessary is indicative of a sorry state of affairs. Paramedics say the delays are preventing them from responding to calls and fear they could lead to a tragedy. I share these fears.
As recently as last week it was reported that the hospital was the second worst in the North East for “hospital hand-over delays” of more than two hours. Any hospital hand-over delay of more than two hours is classified as a “serious incident” by the North East Ambulance Service. Just as concerning, in December it failed to meet national targets of responding to 75% of the most serious incidents – classified as “red incidents” – within 8 minutes. Its result was 69%.
Accident & Emergency departments are the foremost example of NHS frontline services. If these appear to be failing then it is hard to deny that something is not right. I don’t think it is right for patients to be queuing up in a corridor as was the case with Gladys Herbert who’s described what was happening “as plain as the nose on my face there’s not enough beds and not enough staff in the hospital”. This occurred at James Cook when there was a queue of up to 10 ambulances at one point. This is quite frankly an appalling risk to patient safety. The Prime Minister personally promised to protect the NHS, but he is leaving patients like Mrs Anderson and Mrs Herbert waiting longer in pain and discomfort.
Some may say it is merely scaremongering but I believe frontline staff when they say:
“Somebody is going to die somewhere down the line and it could be the most vulnerable, children. Families of sick people arrive at hospitals and expect to find them in a bed, but they are still outside in an ambulance.”
In fact, a tragedy has already taken place. Last year an ambulance crew brought a patient to the hospital but he was not officially handed over to A&E staff. Before he could be seen by either a nurse or doctor he went into a fatal cardiac arrest. The patient, who has not been identified, died at James Cook University Hospital having waited for emergency treatment for more than two hours.
These delays are stretching resources all over the place. Ambulances from as far as Lancashire were being brought in to cover other emergencies. I fear that, with changes in NHS provision elsewhere in the North East and North Yorkshire, James Cook’s resources could become even more stretched.
However I also believe that due to the general reduction in surgeries in some areas of the North East reducing their late opening times for out of hour’s appointments this has generated further pressure upon regional A&Es. For example, in County Durham 69 GP surgeries offered late opening appointments that’s now down to 61 surgeries, a 7.6% drop. In Newcastle 33 GP surgeries offered late appointments in 2011, that’s dropped to 24 surgeries in 2012-a 25% drop. And in Hartlepool 15 GP surgeries offered late appointment times in 2011 this has dropped to 10 in 2012- a 31.3% decrease.
Walk in centres in my constituency, Middlesbrough and Redcar and Cleveland help alleviate stress upon A&E with adequate triage assistance. especially with less affluent transient populations that are often not on GP registers.
As the Minister is aware following the meeting he kindly agreed to have with me, alongside a representative of the Trust, urgent care provision in East Cleveland is facing particular problems also. Whilst the Trust claims to be taking steps to resolve these problems, I fear that in the interim–and possibly in the longer term if the issues are not resolved–that a reduction in urgent care provision in East Cleveland could just further increase the demand faced by James Cook’s Accident and Emergency department as patients search for alternative treatment.
Similarly, changes in provision in Accident and Emergency departments in North Yorkshire could increase the pressures faced by James Cook. In the neighbouring constituency, I know in Scarborough, whilst the Trust there has given assurances as to the future of overnight A&E services, local people feel that there are uncertainties over the future of services. In Northallerton, I know that the Foreign Secretary has been campaigning against cuts to services at the Friarage, particularly to maternity services. I fear that if services at these hospitals are reduced, we could see additional demand placed on James Cook, despite the fact that it is already struggling to cope with the demands placed upon it.
When someone is taken to hospital in an ambulance, most reasonable people would expect them to receive care and treatment very quickly. Whilst I accept that demand is difficult to predict, I certainly do not expect my constituents to have to wait two and a half hours after been taken to hospital by paramedics.
There is a very real danger that the situation could deteriorate. At the moment, the capacity for the hospital as an A&E department is 60,000 patients per year. This year they are expecting almost double that figure at 105,000. It is a time bomb waiting to to go off that will have repercussions across the region as the hospital receives patients from Yorkshire Ambulance Service and the Great North Air Ambulance.
I do not hold nurses or doctors responsible for what is taken place in A&E departments throughout the region; after all, over 7000 nurses have been cut across the NHS since May 2010. I think it is more likely to be caused by the budgetary squeeze and organisation changes local NHS Trusts are finding themselves in due to the Government’s cuts and unnecessary, expensive NHS bureaucratic re-organisation.
I hope the examples that I have used make it clear that there are serious problems on Teesside and they cannot be allowed to continue. I appreciate that the Minister is currently monitoring the situation with regards to urgent-care staff in other hospitals in my constituency and I would be grateful if, alongside this process, he monitors closely A&E performance at James Cook University Hospitals and intervenes before we find ourselves in a crisis