Turning a cleaning cupboard into a GP consulting room – the NHS this week

By Richard Grimes

We monitor 700 news websites across England for current stories about local NHS services. This update is collated from this monitoring over the last week. The national media are led by press releases from the Department of Health, pressure groups and metropolitan think tanks. Sentinel News reflect local priorities about local NHS services. (All links go to the original news reports)

A&E and ambulances

We have not had severe cold weather this winter, but A&E departments are still struggling to meet demand. Delays in A&E result in ambulances queuing to hand over patients, and this has the potential to adversely affect response times to emergencies.

  • There is an ambulance crisis brewing in Essex. The ambulance trust revealed that “crews are unable to attend hundreds of emergencies each day due to delays handing over patients to hospital A&E departments” and this led the chief executive to suggest: “We are exploring whether using taxis would be a viable option to collect and convey patients who may need a hospital medical assessment, but who do not have serious or life-threatening injuries and who are perfectly mobile.”
  • Demand pressures at the emergency departments at Telford’s Princess Royal Hospital and Shrewsbury Royal Hospital in Shropshire meant “an average of 25 ambulances a day experiencing delays [longer than 30 minutes] at each hospital”. The chief executive of the hospital trust said “we’ve seen a 15 per cent increase in attendances at our A&E departments which is a significant figure, as our attendance levels over the course of a year are in excess of 100,000 people”. At the weekend half of all ambulances sent to the two hospitals waited for 30 minutes or more when the target handover time is 15 minutes.
  • A&E attendances at Peterborough City Hospital reached “unprecedented levels” with a “40 per cent rise in the number of people the hospital would have expected on a normal Sunday and Monday”.
  • Yeovil Hospital has been on “black alert” for two weeks, meaning that the hospital is full to capacity. This is its third period of black alert this winter. This financial year the trust have borrowed £23 million – nearly 19 per cent of their annual budget – from the Department of Health to cover their annual deficit. The trust blames spending on agency staff to help maintain a safe staff to patient ratio during busy periods.
  • Attendances at A&E have risen across the West Country with some departments reporting year on year increases of 45 percent. Over the weekend the Royal Cornwall Hospital was on black alert for the fourth consecutive weekend after “hundreds of people flooded through the doors of A&E”.
  • Royal Lancaster Infirmary is seeing an “extreme rise in activity” and for the second time in two months that it has issued a warning advising people to only visit A&E in an emergency. The North West Ambulance Trust report 11,005 “red calls” in the last month compared with 7,921 in the same period last year.

GP shortages

GP services are under pressure from an increasing, ageing population, and recruitment and retention issues.

  • At a public meeting in Tetbury, Gloucestershire, the retirement of a local GP and the pressure of new housing were cited as challenges facing the local surgery. The 818 new houses in the town will mean an additional 2,000 patients in the next five years.
  • In Gainsborough, Lincolnshire, a local GP told the BBC that the shortage of GPs in the area was “a serious situation” and described it as “a crisis”. Furthermore, the local NHS community health trust says there is no out of hours service in the Gainsborough area “due to difficulty in finding GPs to cover”.
  • In response to the rising demand for GP services in Braintree, a local surgery has had to “convert a tiny cleaning cupboard into a consulting room” and has recruited an additional nurse practitioner to use the room. Three of the four practices in the town have closed their patient lists to new patients while waiting for the council’s decision on a new “super practice”. The council cabinet member for economic growth said “I make no apology for it taking time, it’s so important we get this right”.

Trust deficits

This is the last month of the NHS financial year, so in the next couple of weeks trusts across the country will be reporting their interim results for the year.

Epsom and St Helier University Hospitals NHS Trust broke even last year, but this year they estimate they will be £28m in deficit. The trust have taken out a £25m loan from the Department of Health to cover part of the deficit. The Chief Finance Officer said that “the biggest reason for this deficit has been a pay increase”.

Service changes

A report this week on the Liverpool Community Health NHS Trust said that the trust, which runs more than 65 community health services, was “hellbent on aggressive cost-cutting that put patients at risk”. The local MP, Rosie Cooper, said it was “an NHS scandal similar to Mid Staffs but in community services, rather than a hospital”.

A recent decision by NHS England to transfer the £1 billion contract for primary care support services from NHS SBS to Capita means that 11 people in Devizes will lose their jobs. Capita are planning to make 1,000 job cuts across the country, closing 28 of the 30 offices. A spokesman for Unison said the cuts “put three million patient records at risk”.

Protests

Around the country there are changes to NHS services, but it appears that community services like district nursing and community hospitals are in most danger of retendering. Many communities are fighting these changes, through protests or by referring the commissioners to local Health Oversight and Scrutiny Committees (HOSC).

  • An ongoing campaign in Redbridge took a further step this week when “a petition with 1,750 signatures was presented to the council asking hospital management to reopen 32 acute beds closed … last year, and to stop the closure of King George A&E in Goodmayes”. Councillors at a full council meeting declared their support.
  • In Surrey, 200 people protested against the proposed closure of Molesey Hospital. The local CCG said they were having consultations on whether to close the hospital or “relocate services to Cobham or other GP practices”. Local protestors said this “would force patients to pay a £15 taxi fare due to the lack of public transport between Molesey and Cobham”.
  • There was also a protest in Chipping Norton over the future of the town’s community hospital, about to be handed over to the third sector. The protestors’ complaints are that “Oxfordshire County Council took over the 14 NHS-staffed beds without public consultation” and that Oxfordshire CCG “downgraded” the beds to “care home intermediate beds” under a private provider. The hospital is due to be handed over to the charitable Orders of St John Care Trust – which runs the adjoining 36-bed care home – on April 1.
  • Telford & Wrekin Council HOSC examined the recent decision to close Telford walk-in centre which forced 3,000 patients to find alternative GP services. The local CCG said “public consultation will be held to shape a future walk-in service for the borough” but councillors on the HOSC said “it was ‘a pity’ that the service at Sherwood Row will end before the consultation is carried out”.
  • Campaigners in Hull are calling for a rethink over plans by Hull CCG that may “axe minor injuries units in Hornsea, Withernsea and Driffield” and threatens closure of Hornsea Cottage Hospital. The closures are an attempt to make £14m of cuts.
  • The trade union Unison is concerned about “backdoor privatisation of the NHS” in Southport. The local CCG is re-tendering urgent care services and has told the local NHS trust that it has not cleared the first stage of the tender process. This leaves two private providers, United Healthcare and Virgin Care Services, bidding to run the services which include “GP out of hours, walk-in centres in Ormskirk and Skelmersdale, and the Acute Visiting Service”. United and Virgin, along with two NHS trusts, are also bidding for the community services contract in the same area. The local Unison spokesman said that the potential loss of these services would be “nothing more than the back door privatisation of our beloved NHS”.
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