NHS UNDER PRESSURE: Government MUST Act

NHS Story Headline ImageFollowing analysis of the latest publication of key NHS performance indicators by West Cumbrian MP Jamie Reed, he has demanded that the Government must act to improve services and provide support for overworked and under pressure medical staff.  The local MP warned that staff are being taken for granted by the Government and praised the work of the ‘incredibly hardworking doctors and nurses, on whom we all rely.’

The performance indicators showed disappointing performance across a range of NHS services and Jamie Reed lays the blame firmly at the Government’s door.   The Copeland MP argues that the pressure shown across a range of services is a ‘clear manifestation of the mismanagement of the whole NHS by a Government that shrugs it shoulders and abdicates its responsibility’.  He said that the Government’s inaction on the recruitment crisis facing healthcare in Cumbria and the Government’s failure to provide the necessary resources to key services is being keenly felt.

The West Cumbrian MP went on to say that the Success Regime offers a real opportunity to improve health services in Cumbria, but that the Government must provide the resources necessary to achieve the improvements.  This includes boosting recruitment.

The Copeland MP has written to the Secretary of State for Health demanding intervention and support for Cumbria’s NHS

Copeland MP, Jamie Reed said:

“The Government’s complacency with regard to our NHS services must end.  The NHS in Cumbria is creaking under intense pressure as a result of the Government’s inaction and it is patients that are paying the price.  These pressures are a clear manifestation of the mismanagement of the whole NHS by a Government that shrugs it shoulders and abdicates its responsibility.

“Thousands of people are waiting in A&E and thousands of people are unable to get a GP appointment because the Government have failed to get a grip of the situation.  They’ve failed to intervene to alleviate the ongoing recruitment crisis and they’ve failed to provide the resources that are desperately needed in Cumbria.

“Our incredibly hardworking doctors and nurses, on whom we all rely, are doing everything they can to provide high quality care, but the Government’s inaction means they are working with one hand tied behind their back.  It is time for Jeremy Hunt and the Government to step up and provide our wonderful NHS staff with the support they desperately need.

“In Cumbria, we have a fantastic opportunity to undertake an innovative approach to improve our health services.  The Success Regime is a real chance to improve our key services, but the Government must play its part.  It is clear that more resources are needed and the Government has to provide these so we can achieve our aspirations for the NHS in Cumbria.

“I’ve said time and again, that the people of West Cumbria must have safe and timely access to key services.  Nothing on this front has changed.  Part of the responsibility facing the Government is to ensure that the NHS in Cumbria has the resources it needs to retain and improve services at the West Cumberland Hospital.  It is now time for Government to step up and play their part.”

Statistics

Accident and Emergency

When the Coalition Government took office in 2010, they lowered the Accident and Emergency target of seeing patients within four hours to 95% from the 98% target under Labour.  In February 2016, North Cumbria University Hospitals Trust saw 80.5% of patients within 4 hours of them attending A&E:

  Number or people attending A&E Number of people waiting more than four hours Percentage of people seen within four hours
February 2016 6,905 1,344 80.5%

SOURCE: NHS ENGLAND

This was slightly below the average for England.  Performance in A&E has been declining nationally and patients in Cumbria are being affected.

Since Jeremy Hunt became Secretary of State for Health, North Cumbria University Hospitals Trust has hit its A&E target just twice in 13 quarters.

The Graph below shows the performance over the last three-and-a-quarter years since Jeremy Hunt was appointed in September 2012.

Graph

SOURCE: NHS ENGLAND

GP Patient Survey

In February, more than 1,000 extra people visited Accident and Emergency at North Cumbria University Hospitals Trust compared with the year before.

According to the most recent GP Patient Survey, over 6,000 people turned to another NHS service, including A&E after not being able to get a convenient appointment with their GP.  A further demonstration of the pressures that GPs are under is that 22.51% of patients were unable to get an appointment or had to wait a week or more to see their GP the last time they tried.

Almost 1 in 10 people were unable to get an appointment at all the last time they tried.

Ambulance Services

The quality indicators for the North West Ambulance Service has also shown a deterioration in performance over the last year.

In February 2015, 91.4% of Category A calls were responded to within 19 minutes; in February 2016, this had fallen to 88.1%.  Government guidance states that ‘irrespective of location’ the 19-minute standard should be achieved in 95% of cases.  It also states:

“Patient outcomes can be improved by ensuring patients with immediately life threatening conditions receive a response at the scene, which is able to transport the patient, in a clinically safe manner, if they require such a response.”

The timeliness of ambulances has also worsened.  The table below shows the median time to arrival of ambulances for Category A calls in minutes.  It also shows the time in which 95% and 99% of ambulances arrive.

  Median 95th Percentile 99th Percentile
February 2015 7.2 23.8 45.7
February 2016 7.7 28.8 57.3

This data shows that in February 2016, 1% of ambulances took longer than 57 minutes to reach the patient.

NHS Staff Survey

The impact of the pressures on NHS services throughout Cumbria is being keenly felt by staff working in the NHS in Cumbria.

The findings from the most recent NHS Staff Survey shows that staff at North Cumbria University Hospitals Trust feel under pressure:

  • 58% of staff believe there is not enough staff at the organisation for them to do their job properly
  • A third of staff also say they are unable to meet all the conflicting demands on their time
  • 12% of staff say they work six or more unpaid hours each week on top of their existing contracts.

Jamie Reed’s full letter to Jeremy Hunt is here:

 

The Rt Hon. Jeremy Hunt MP

Secretary of State for Health

Department of Health

Richmond House

79 Whitehall

London

SW1A 2NS

 

15th April 2016

Dear Secretary of State,

NHS Services in Cumbria

The recent publication of the Combined Performance Summary for the NHS in February 2016 paints a worrying picture of services in England and in Cumbria.

The challenges facing the NHS in Cumbria are well documented and I have written to you many times detailing the acute issues we face.  The geographical and demographic challenges of providing health care in Cumbria are exacerbated by a worsening recruitment crisis, which you have so far refused to intervene in, and an underfunding of public health services which sees some affluent areas receive considerably more funding per head than Cumbria.

This picture is further worsened when combined with pressures on Primary Care and other issues that have an impact on healthcare provision such as a lack of investment in key infrastructure which has an effect on access to services.

The Success Regime offers a real opportunity for services in Cumbria to be improved.  Only by taking a holistic view of the challenges facing the NHS in Cumbria and only through proper engagement with the community who rely on these services can we start to make sustainable improvements.  As important as these principles is the practical issue of resources.  Will you commit to ensuring that the NHS in Cumbria has the resources it needs to achieve the aspirations of the Success Regime, the NHS and the community as a whole with regard to our NHS?

When Sir Bruce Keogh conducted his review into the issues at North Cumbria University Hospitals Trust which was published in July 2013, he stated: “I believe we can make significant progress in the next two years.”  The hard work of doctors, nurses and other staff within the NHS means that the Care Quality Commission can see improvements to care being made.  That is to the credit of the staff involved.  This, however, gives the Government no reason to be complacent.

The performance statistics published on 14th April demonstrates that the NHS in Cumbria is creaking under pressure.  Patients are waiting longer, staff are under more pressure and the whole system is feeling it.

In Accident and Emergency in February, 1,344 patients waited more than four hours to be seen in Cumbrian hospitals.  Almost 1 in 5 patients that attended A&E waited more than four hours to be seen.  This is not acceptable, but things are getting worse not, better on your watch.  In the 13 quarters you have been Secretary of State for Health, North Cumbria University Hospitals Trust has met it’s A&E target in just two of the quarters.  In four of the last five quarters, performance has been below 90%.

It is clear that the Government’s failure to take action on the ongoing recruitment crisis at North Cumbria Trust, despite repeated requests by me and others, is having a major impact.  The NHS Staff Survey shows that 58% of staff at the Trust believe there aren’t enough staff at the organisation for them to do their job properly.  A third of staff say they are unable to meet all the conflicting demands on their time and more than 1 in 10 work six or more unpaid hours each week on top of their existing hours.  This is unsustainable.  Will you take action to boost recruitment at North Cumbria Trust?

Pressures on A&E are made worse by the intense pressure on primary care.  The most recent GP Patient Survey showed that around 6,000 patients in Cumbria turned to other NHS services, including A&E, because they couldn’t get a convenient appointment with their GP.  It is time for Government to support GPs providing primary care in rural communities.  Will you set out the steps you will take to take the pressure off GPs in Cumbria?

The pressures are also being felt in the ambulance service with ambulances taking longer to reach patients.  In February, just 88.1% of Category A calls were responded to within 19 minutes; down from 91.4% compared with last year.  At a time when demand is increasing, will you provide the service with the funding it needs to improve performance?

One of the fundamental points underpinning health care in Cumbria and especially West Cumbria, is ensuring the retention and improvement of services at West Cumberland Hospital.  The Government must ensure that key services, such as consultant-led maternity services are retained at West Cumberland Hospital.  It is inconceivable to expect patients to travel over an hour to reach the Cumberland Infirmary, Carlisle to access key services.   Part of ensuring the retention of services is to ensure that Phase Two of the redevelopment of West Cumberland Hospital goes ahead.  Will you commit to ensuring that the resources necessary to achieve this will be available to North Cumbria University Hospitals Trust?

The performance indicators clearly show that there is a great deal of hard work to be done by all stakeholders, including Government.

There are still many challenges that need urgent attention.  I look forward to your speedy reply.

Yours sincerely

Jamie Reed MP

 

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