Friday, 20 December 2013

My visit to A & E at Royal Blackburn

This morning I visited Royal Blackburn hospital to discuss how the A and E service are coping and to show his support for the hard working staff there.

The cumulative actions of the Tory-led Government have meant that across the country the NHS is struggling to deal with the A and E crisis. This situation is predicted to become worse over the coming winter months with more ambulances queuing up outside A and E units and more people waiting longer before being seen.

Under the previous Labour Government, A and E was performing well with 98% of patients seen within 4 hours. But since the 2010 general election, the number of patients waiting over 4 hours has more than doubled and ambulance queues have doubled as well.

The increase in A and E waiting times has been caused by cuts to social care budgets, meaning older people are ending up in hospital because there is no one else to take care of them. There have also been 6,642 nursing jobs cut and a needless £3 billion top down reorganisation which have made the situation in A and E much worse.

I gained a good insight into how front line staff are coping with the winter pressures now facing them. I pay tribute to the staff at Royal Blackburn Hospital who are doing a hard job in very difficult circumstances.

During my visit I spoke with consultants, managers and nursing staff about staffing levels and morale, waiting times, ambulance waits and impending cuts.

It was clear that the Keogh report had been a shock and that the hard working staff had used it as a springboard for change. Morale was high even though there was some under staffing in the main due to the attraction of major city hospitals. What was clear was the physical change, extra beds in A and E and extra capacity, a robust plan for the winter spike in patient numbers including close working with Ambulance Trust, paramedics, and spare capacity in in patient wards.

However, here in East Lancashire it is clear that patients and hospitals are paying the price for David Cameron’s mismanagement of the NHS and for his decision to proceed with a top-down reorganisation that he promised wouldn’t happen.

The unfolding crisis in A and E is a clear symptom of a system under pressure and there is no more visible sign than ambulances queuing up outside A and E units and patients waiting longer to be seen.

What is clear is East Lancashire health care is taking a financial hammering. A recent CCG funding paper for East Lancs states that £51m worth of central government savings need to found; that a further £15milion must be found for the Health and Wellbeing Board and this week the CCG found out that Lancashire's healthcare budget would receive a further government cut of £20m per annum on top to fund healthcare in the south and wealthy areas.

Add to this rapidly rising demand for healthcare in East Lancashire further stretching resources.

In the last 12 months, a million people have waited more than four hours in Aand E. Four-hour waits in A and E are up, trolley waits are up, ambulance queues are up, delayed discharges are up and we’re even seeing people being ferried to hospitals in police cars because ambulances aren’t available. Royal Blackburn hospital A and E  is the busiest in the North West and local Police inspector has confirmed to me that they are in this area indeed taking patients to A and E to free up police officer time.

David Cameron promised to protect NHS budgets and promised that there would be no more top down re-organisation. Neither of which has happened.

East Lancashire's A and E faces future pressures.

In the past, people who couldn’t get see a GP would have been able to go instead to NHS Walk-In Centres. But the Government has closed one in four of them nationally, along with NHS Direct and now Accrington Victoria Walk-In Centre used on some 36,000 occasions is under threat. Is it any wonder that so many people are left with no alternative but to go overstretched A&E departments?

A Care Quality Commission report found that 1 in 10 of the over 75s and 1 in 5 of those over 90 (a 66% rise) are being admitted to A&E needlessly.

New figures published by the Health and Social Care Information Centre show that there are now 852 fewer GP surgeries offering extended hours than in 2009.

According to the GP patient survey for 2013, 1 in 10 people said they went to A&E because there weren’t any available GP appointments. The current government have scrapped the 48 hour guarantee, and this has further piled the pressure on A and E.

With rising demand, fewer resources and smaller staffing budgets and cuts to preventative care such as GP access simple hip or eye operations only adding to A and E demand is the future of our local A and E a much bleaker one? The one positive aspect of my visit was the staff and it they who shoulder the burden of a mismanaged NHS.