"We are constantly failing to meet our own and our patients expectations. We apologise to them and we also empathise with them. We feel handcuffed and paralysed working in this current NHS..." today's letter to Theresa May signed by over 2,000 senior NHS doctors.
At last week's meeting of the Salford Clinical Commissioning Group (CCG) a report was presented which included officially unpublished data showing that on 13th December there were "six breaches of the twelve hour trolley target at Salford Royal NHS Foundation Trust".
The report added that "These are the first twelve hour trolley breaches since the establishment of the CCG" and that "the Urgent and Emergency Care system has been under sustained pressure...within Salford over the last three months".
While the twelve hour trolley waits for patients are being reviewed by the Serious Incidents Panel, the latest statistics for Salford health care are showing breaches all over the place, which make horrific reading.
At Salford Royal Hospital A&E, the target for patients waiting no more than four hours is 95%. In November 2015 this was missed with 92.2%. In November 2016 it had slumped even further to 80.2%.
The reason for this, the CCG report states is that "Delays to Transfers of Care and an incredibly large increase in Length of Stay is stopping flow through the hospital and causing delays within the Emergency Department". While it's been generally thought that this is caused by 'bed blocking', the report shows that cuts to Trafford General Hospital Urgent Care Centre are having a major impact on Salford Royal Hospital...
"Since the new operating hours were enforced on 3rd October 2016 there has been an increase in admissions of Trafford patients by an average of two per day and these patients have a length of stay which is roughly three days longer than Salford resident patients" the report states
"This has reduced the Trust's ability to maintain patient flow through the hospital" it adds "As at 1st Dec 2016 there were 88 Trafford patients in Salford Royal and this accounts for more 10% of the hospital's bed stock."
The report states that the issue has been "escalated" to a Greater Manchester level. And in the risk section it is noted that "Decisions made by Co-commissioners and Specialist Commissioners may lead to unintended/unforeseen impacts which affect Salford CCG's ability to deliver its own priorities".
In other words, what is happening is that cuts to one hospital are having a huge knock-on effect to others. It's going to get worse, with somewhere in the region of over £1billion of "efficiency savings" coming our way before 2020 (see here). And the impacts have not been 'unintended' or 'unforeseen' by anti-cuts campaigners, who have been warning about it to anyone who will listen.
Last Saturday, there was even a 'die-in' at the MRI in Manchester to highlight the point (see previous Salford Star article – click here)
Meanwhile, the percentage of Salford cancer patients who received their first treatment within 62 days fell from 100% in November 2015 to 84.2% in November 2016...Targets were also breached for 'Patients feel supported to manage long term conditions'; Non-elective admissions; Satisfaction with Accessing Primary Care; Diagnostic Test Waiting Times; Mixed Sex Accommodation and Incomplete Pathways.
...In Greater Manchester, the percentage of patients in the emergency Category A Red 1 (critical) who had an ambulance respond within the eight minute target fell from 73.4% in November 2015 to 62.8% in November 2016 (target 75%)...and those in Category A Red 2 fell from 68.5% in November 2015 to 60.4% in November 2016...The 19 minute ambulance response target of 95% was also missed, falling from 92% in November 2015 to 86.8% in November 2016.
"Increased activity and increased handover times at some GM Trust A&E departments continue to negatively impact on vehicle availability on the road" states the report.
The report also notes that in Salford over 65% of care homes (24 out of 37) are rated as 'requiring improvement' overall, while four have been given an 'inadequate' rating for safety.
Community Based Adult Social Care is also shocking, the report notes... "The position in Salford is worse than both the National and Greater Manchester position, most notably in the safe domain with over 70% of providers rated as either inadequate or requiring improvement".
Salford's big plan is to 'integrate' health and social care*, together with huge cuts to budgets based on keeping people out of hospital. But minutes of a CCG meeting in November show that this is not working...
Steve Dixon, Chief Finance Officer for the CCG, "advised that reductions have not
been achieved as expected on some contracts - the ambition of Salford's locality plan was to reduce unplanned admissions into hospital and this year's contract activity was reduced to reflect that ambition" the minutes state "However, contract volumes continue in line with previous years, resulting in an overspend on the contract plan."
Health care in Salford, in line with the rest of the country is in a crisis and a mess, with cuts and 'efficiency savings' making matters even worse.
Today, more than two thousand senior NHS doctors have signed a letter calling on Prime Minister Theresa May to increase spending on health and social care because "unacceptable levels of safety concerns" mean things "simply cannot continue" the way they are.
The doctors who organised the letter - Anita Sugavanam, consultant anaesthetist, and Rob Galloway, an emergency medicine consultant, at Brighton and Sussex University Hospital - said it is one that they hoped "we would never have to write."
In the letter they say: "We are constantly failing to meet our own and our patients expectations. We apologise to them and we also empathise with them. We feel handcuffed and paralysed working in this current NHS. We are exasperated and feel demoralised because we are not able to provide and develop the excellent care we were trained to give. We are simply fighting fires on a daily basis. There is a real risk of a brain drain at our level from the UK if this government does not listen to us."
They urge May to act on a letter sent in January from three leading MPs who urged her to invite all political parties to discussions in a bid to reach a cross party agreement on the future of healthcare and social care funding.
They also call on May to act on the recommendations made in the Barker commission in 2014 which said that more people should have free social care paid for by tax and welfare changes and for the percentage of GDP spent on healthcare to rise to at least 10%.
The doctors argue: "It is impossible to provide effective efficient patient-led innovative healthcare which is free at the point of contact when we spend less on healthcare than other comparable OECD countries."
They conclude by saying: "This is not a political statement. Again we reiterate that we represent the most senior tier of healthcare workers and we are writing to you for the first time en masse. Do not ignore this letter and provide a response as soon as possible."
On March 4th there is going to be a huge #OurNHS demonstration in London - see these websites for further details... www.healthcampaignstogether.com or www.thepeoplesassembly.org.uk
* See also previous Salford Star article - If you're elderly or ill it's Do It Yourself - click here
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