County's A & E waiting times 'unacceptable'

The Oxford Times: Peter Casbolt Peter Casbolt

WAITING times at Ox-fordshire’s accident and emergency departments have plummeted to their worst level in more than two years.

Experts last night said the “unacceptable” delays – which have steadily got worse over the past six months – had led to queueing ambulances and demoralised nurses.

Almost a quarter of A&E patients were not seen within four hours at Banbury’s Horton General and the John Radcliffe Hospital in Oxford in the week ending April 7.

The statistics have fallen from an average of 98 per cent across October last year to 83 per cent in March. The average for the first three weeks of April is 81 per cent.

Oxford East MP Andrew Smith said he would seek assurances from Oxford University Hospitals Trust (OUHT) that steps were being taken to address the issue.

The Government’s target is to treat emergency patients within four hours of their arrival 95 per cent of the time. Until 2010, the target was 98 per cent.

OUHT said overall hospital admissions across all departments had risen and the recent cold weather had added to pressure on the A&E departments.

Mr Smith said: “It’s very worrying and unacceptable that nearly a quarter of patients arriving at A&E are having to wait four hours or more.

“It is clear that the JR, like a number of other hospitals in the South East, is under colossal pressure.

“I am seeking assurances from the hospital chief executive that steps are being taken to bring the service back to where it should be.”

He questioned the Government’s scrapping of NHS Direct in favour of the 111 phone number, which he said was not “such a trusted replacement”, and added that bedblocking was not helping.

OUHT was seeing about 85 per cent of patients within four hours in December 2010 and January 2011. The figure rose to 95 per cent in March 2011 and was fluctuating around the Government target until April 2012.

It then dropped to 86 per cent but rose again in the following month, reaching a high of 98 per cent in October last year.

But from there the statistics fell, to 94 per cent in November and December, 91 per cent in January, 90 per cent in February and 83 per cent in March.

For the week ending April 28 – the most recent statistics – the trust was at 89.3 per cent.

It was 90.6 per cent at Great Western Hospitals NHS Foundation Trust – which runs Swindon’s Great Western Hospital – and 88.7 per cent at the Royal Berkshire NHS Foundation Trust, which runs Reading’s Royal Berkshire Hospital.

Oxford West & Abingdon MP Nicola Blackwood said: “It is obviously important that the Oxford University Hospital Trust establish why their A&E waiting times have been below the national average since the end of February.

“There could be a number of reasons for this which are temporary, like falls and flu epidemics associated with bad weather.

“But there are also possible systemic issues like problems with patients accessing out of hours GPs or bed-blocking caused by delays in care home placements or other social care support.”

Jacquie Pearce-Gervis, chairwoman of Oxfordshire-based watchdog Patient Voice, said: “I think it is very bad indeed and something should be done about it.”

She suggested GP surgeries should be open longer into the evenings and at weekends so patients did not feel they had to use A&E.

Royal College of Nursing south east regional director Patricia Marquis said: “We know from speaking to nurses there that they are absolutely trying their best to deliver excellent care under difficult circumstances and are getting demoralised with the situation.

“When you have ambulances queueing at A&E the pressure is immense. More needs to be done to address staffing on the front line to ensure that patients can be cared for in the best way.”

South Central Ambulance Service spokeswoman Gill Hodgetts said queueing ambulances had been “an issue” at times but said demand on services had been particularly high recently.

OUHT said it had seen an increase in overall admissions over the last three months due to health issues associated with the colder weather, particularly respiratory problems including flu and pneumonia. Inpatient and daycase admissions increased from 174,494 in 2011/12 to 198,622 in 2012/13.

Director of clinical services Paul Brennan said: “Our teams are working hard to ensure that patients are received, triaged and treated promptly.

“For example, during busy periods the hospital teams redeploy staff to areas of high demand, free up capacity elsewhere in the hospital, and an experienced nurse supports ambulance teams during the brief periods that patients are waiting to be admitted to the department.”

He refused to explain further why waiting times had risen so severely since February or any more details about exactly what was being done about the problem.

The Oxford Mail asked whether staffing was an issue at the A&E departments, but the trust refused to comment further.

 

CASE STUDY ONE

PETER Casbolt, 86, above, waited just 20 minutes to be seen at the John Radcliffe after ambulance personnel suspected he may have meningitis.

Mr Casbolt dialled 999 on Saturday, March 9, at about 5am with “very severe pain” at the back of his head. A paramedic arrived within five minutes.
He was taken to A&E at the John Radcliffe and seen by a doctor within 20 minutes. He had several tests, including a brain scan and X-ray, within an hour.
After being in A&E for 90 minutes, he was then passed to an assessment ward, where he stayed until he was discharged on Monday, March 11.
The retired chartered engineer said: “I am fairly certain because of the time I went in – very early Saturday morning – there was not much about then.
“You can imagine Friday or Saturday night being horrendous.
“But I thought it was a marvellous service. As far as I was treated, it was exemplary – the waiting time was almost zero.”

CASE STUDY TWO

ANN Tomline, left, from Long Wittenham, waited for three-and-a-half hours with an ambulance crew to join the queue at the John Radcliffe Hospital last month.
She had a bad fall on Saturday, February 23, and, although it turned out she had only pulled ligaments, she said she was in agony and taken by ambulance to hospital.
Mrs Tomline, a retired nursery school manager, said: “We waited with the ambulance people at A&E for three-and-a-half hours to join the queue. The ambulance people had to stay with me all that time.
“We were in the corridor and it was two degrees below freezing – the door was wide open – and the ambulance people got me extra blankets.”
She said she then had to wait another hour in the queue at A&E to be seen by a nurse. She only left A&E the following Monday morning when a bed became free elsewhere.
She said: “All the time I was there I was hearing people saying ‘this hospital is in crisis’. It was so, so busy.
“They were run off their feet and there is not enough staff.
“I was treated diabolically, but I think it is a lack of care through not having time.
“I will have to be on death’s door to go in there again. It was horrendous.”
Asking patients to wait with an ambulance crew before joining the A&E queue is dubbed “patient stacking”.
It means that although the patient may have waited for more than four hours, they did so outside the A&E queue and therefore do not add to negative waiting times statistics.

The best - and the worst

OF the 145 NHS organisations in England with a major A&E department, Oxford came 12th worst for meeting the four-hour target in the week ending April 7, 2013. The worst were:
University Hospital Southampton NHS Foundation Trust: 60.4 per cent
Weston Area Health NHS Trust: 63.8 per cent
University Hospitals Coventry And Warwickshire NHS Trust: 67.9 per cent
The Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust: 68.9 per cent
North West London Hospitals NHS Trust: 69.7 per cent
University Hospitals of Leicester NHS Trust: 70.4 per cent
Kettering General Hospital NHS Foundation Trust: 72.0 per cent
Heatherwood And Wexham Park Hospitals NHS Foundation Trust: 74.2 per cent
Royal United Hospital Bath NHS Trust: 75.4 per cent
North Bristol NHS Trust: 76.0 per cent
Worcestershire Acute Hospitals NHS Trust: 76.4 per cent
Oxford University Hospitals NHS Trust: 77.8 per cent
The five best trusts across England in the week ending April 7 were:
Gateshead Health NHS Foundation Trust – 98.5 per cent
Chelsea And Westminster Hospital NHS Foundation Trust – 98.2 per cent
Alder Hey Children’s NHS Foundation Trust – 97.5 per cent
Northumbria Healthcare NHS Foundation Trust – 97.4 per cent
Birmingham Children’s Hospital NHS Foundation Trust  – 97.4 per cent

Comments (2)

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11:01am Tue 7 May 13

Shaun the Faun says...

Maybe targets weren't such a bad thing after all...
Maybe targets weren't such a bad thing after all... Shaun the Faun

1:03pm Tue 7 May 13

Andrew:Oxford says...

Open walk-in GP practices in Oxford. Perhaps in one of the retail parks?

That should relieve the pressure on A&E from people who don't feel well enough to wait a fortnight for a GP appointment.
Open walk-in GP practices in Oxford. Perhaps in one of the retail parks? That should relieve the pressure on A&E from people who don't feel well enough to wait a fortnight for a GP appointment. Andrew:Oxford

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