‘Extraordinary pressures’ causing Northern Lincolnshire NHS Trust to “fall far short” of performance expectations- says NHS boss
The trust's performance was discussed during a meeting this week
“Extraordinary pressures” have caused Northern Lincolnshire hospitals to “fall far short” of the trust’s own performance standards lately in some areas including A&E and ambulance handover times, an NHS boss has said.
Northern Lincolnshire and Goole NHS Foundation Trust chief executive Dr Peter Reading made this admission of the Trust’s performance during a meeting of its board of governors on Wednesday, January 11. Besides the demand for services, it was also heard that hospitals experienced significant pressures on staffing numbers over Christmas and New Year due to a high staff sickness rate.
At any one time around five per cent, or one in twenty staff, had been unavailable in recent weeks largely due to high sickness rates, the governors were told by NLAG’s chief operating officer Shaun Stacey. However, it was not all sobering news.
Despite the strain faced, NLAG has not had to declare any critical incident so far this winter, and the increased use of same-day emergency care was also welcomed as part of easing A&E pressures. Trust bosses were hopeful too that it could be moved out of financial special measures from potentially as early as February.
Stressing the background to the whole of the NHS of very high levels of emergency attendances and submissions, difficulties in social care capacity and 130,000 vacancies across the NHS, Dr Reading said hospital staff had “worked tremendously hard to maintain services”. As well as working to reduce its own elective, cancer and diagnostic backlogs, NLAG has also provided “mutual aid” to Hull, York and Scarborough hospitals to take on some of their elective backlogs.
“The combination of all of this means that our staff are working under extraordinary pressure and the Trust performance in a number of areas falls far short of what anyone would want it to be, in particular with respect to ambulance handover times and the length of time patients stay in A&E. It should be noted, however, that the Trust’s elective performance, while regrettably well below where it was as we entered the pandemic, remains among the best in the region.”
In the week ending December 18, NLAG ranked 72nd out of 116 NHS hospital trusts for its performance in seeing patients in A&E within four hours, with 57.6 per cent of patients seen to in that time. Dr Reading also expressed again his “sincere regrets for those patients who do not get the service they would expect because of the pressure the services are under”.
In his operational update Mr Stacey said Scunthorpe General Hospital and Diana, Princess of Wales Hospital, Grimsby, and Goole & District Hospital were all working under “acute stress”. Emergency and special care had been sustained despite “some incredible staff pressures” faced. Respiratory viruses primarily and Covid-19 had combined with the typical regular annual leave during the holiday period to result in a five per cent absence of NLAG’s workforce in recent weeks.
It was in this context that mask wearing has been reintroduced at Northern Lincolnshire and Goole hospitals to try and protect the health and wellbeing of staff. The hospitals continue to be challenged every day with demand and capacity to admit patients.
There had been “long delays in getting patients out of emergency departments into wards” of hospitals. That “poor flow” had in turn impacted ambulance handover times.
This poor flow was less to do with discharge issues, than the severity of illnesses and injuries people have had. “Our biggest problem is the acuity of patients that we are seeing in our hospital beds.”
Urgent Care Service (UCS), for illness or injury that requires urgent attention but is not life-threatening, and Same Day Emergency Care (SDEC), care on same day for people without admitting them to a hospital and with the aim to send them home the same day, did help general A&E pressures. These can be accessed without A&E processing.
But both services shut at 8pm in Scunthorpe and Grimsby. “When it shuts at 8pm, it becomes a real problem for us,” Mr Stacey said of the UCS, with it resulting it in problems in flow in A&E and it was similar with SDEC.
NLAG hopes to make its SDEC services 24 hours a day. “We are working really hard so that next year we may be able to change this, but at the moment we do not have the funds to open it.”
November saw the highest monthly number yet of new patients, 2,004, attend SDEC in Scunthorpe and Grimsby. “To know that you can attend hospital in an emergency, have your diagnostics done, be treated and back home within 12 hours is a really good thing,” Mr Stacey said, welcoming the increased use of SDEC.
NLAG’s board of governors were also told by Dr Peter Reading that he was hopeful that by the end of February it “will be lifted out of financial special measures”. It was placed under the extra support measures in March 2017 and was unable to be moved out of these in 2019 when “serious underlying problems” were discovered”.
The “high costs of agency temporary staff” meant NLAG is still under “substantial financial pressure”, but it is forecast to meet by the end of the financial year its own budget plan. “At this point in time, there’s nothing to suggest NLAG are particularly better or worse than anyone else,” Dr Reading added in comparison to other hospital trusts.