Letter to Health, Overview and Scrutiny Committee (HOSC)
Dear HOSC Members,
RE: Meeting 3rd March 2015 Agenda Item 6 Worcestershire Acute Hospitals Update.
I would like to bring the following to your attention, and trust it will aid you in your task of scrutinising Worcestershire Acute Hospitals NHS Trust (WAHT) on Tuesday.
1) Harry Turner finally made himself available for interview yesterday by BBC HW after days of silence. Here is the listen again link – http://www.bbc.co.uk/programmes/p02jds6k
Please take the time to listen to this, I would ask you to note Harry agrees the 5 A&E consultants resigning on mass is unprecedented and shocking yet refuses to state why they are leaving. Plus also note the number of times he uses the word unacceptable in relation to problems at WAHT.
2) At WAHT’s board meeting on Monday we heard from the Chairman, Director of Resources, Cheif Operating officer, Cheif Medical officer, Human Resources Director, Non Executive Directors and others. However their was a notable absence of input from Penny Venables the Cheif Executive, this lack of input is a constant and given all WAHT’s problems is very concerning. I hope you take opportunity at Tuesday’s meeting to get her view on things.
3) Save the Alex, MP’s and Council leaders met with Secretary of State for Health and David Flory CEO of the Trust Development Authority on Monday 23rd of February.
These are the key points we raised with them during our meeting, I hope you question WAHT about these concerns on Tuesday.
1 – WAHT is not sustainable financially. It has run deficits for most of its existence. In the last financial year it posted a deficit of £14.2million, and this year is forecasting a deficit of £25million on top of historic debts of £18million. In addition it has or will borrow upwards of £30million to ensure it does not run out of cash. The plan to balance the books is based on a flawed reconfiguration process. It has never been, nor never will be financially sustainable.
2 – It has staffing issues. On top of widespread allegations of bullying and the resignation of 5 ED consultants, we are told by staff they fear patient safety is being compromised due to them being overstretched, having to work their leave to cover shifts and we even have the situation of paediatric nurses being asked to go and work as general nurses in A&E which they are not qualified to do.
Trust wide in the last two months allow more than 5,600 shifts have been underfilled. They have more than 250 vacant posts currently and a locum and agency bill forecast to overspend by £8million
3 – There are quality issues, such as it is missing key cancer targets for 62 day waits, 2ww all cancers and 2ww for breast cancer. It has not hit the A&E target at the Worcestershire Royal for more than a year (even before the latest round of pressure) and the Alex for four of the last 12 months. Staff tell us being treated in the corridor is now commonplace.
4 – HSMR rates are outside the upper control limits, running at 109 for the year to date but in September 2014 (latest available) they were 123 and the trend is upward.
5 – They have missed the RTT target for over a year and the number of inpatients waiting over 18 weeks has risen from 401 in December 2012 to 1,207 now.
6 – The Independent Clinical Review Panel that reported in January 2014 stated that the Alex A&E must remain as WRH could not cope with an extra 6,000 ambulances a year turning up on its doorstep and UHB has no capacity to cope either.
7 – It is said Worcestershire’s health economy could not survive if the Alex was taken over by UHB but we argue it cannot afford to not be taken over by UHB due to the pressure the loss of the Alex would place on the system which would damage patient care
4) In what I believe is blatant disregard for consultation and due process a letter from WAHT Chief Executive Penny Venables was sent to all staff on the 23rd February detailing changes that WAHT want to happen. It is unclear if these changes are inline with the January 2014 independent paneI report prepared by Nigel Beasley. I request HOSC members give their view on this letter which can be read below.
Copy of letter to staff
February 23rd 2015
Future Healthcare in Worcestershire
One Trust, Three Hospitals, Six Steps
I am writing to all members of staff following on from the extra-ordinary CEO brief last week to make clear the Trust’s current plans for services across all our hospital sites. I am acutely aware from my discussions with some of you over the last few days, that the delays we have experienced in taking forward the changes we want to bring in to strengthen services across the Alexandra, Worcestershire Royal and Kidderminster Hospital sites have resulted in a lack of clarity on our plans and the inevitable uncertainty that brings.
I want to share with you the Board’s clear view of how we develop our Hospital Sites. I want to reassure staff that we are totally committed to remaining a Worcestershire Acute Hospitals Trust with all three of our Hospital sites providing services to our population.
The Trust has an ambition to deliver the vast majority of acute healthcare for Worcestershire residents in Worcestershire. Hospital treatment for many medical conditions is getting more effective but it has become very complex and specialised. Outcomes for patients are generally improved by concentrating expertise and resources in specialist centres and in some specialities there is an urgent need to change the way we deliver services. This needs to happen in order to obtain the best outcomes from treatment. There is also a staffing shortage in some specialities.
We see ourselves as one hospital across three sites and believe there are six steps we need to take to secure hospital services in Worcestershire into the future. These six steps form part of the Clinical Model for acute services in Worcestershire. The steps we need to take to achieve the new model of care are:
1. The Alexandra hospital will become a centre for elective surgery with the further development of orthopaedics, benign laparoscopic GI surgery and urology services while continuing a thriving medical service.
2. Continuing to develop an agreed countywide surgery solution with high risk operations will be centralised to Worcestershire Royal Hospital
3. Fracture clinics and trauma assessment will continue at the Alexandra Hospital. People who suffer trauma which requires urgent surgery will be transferred to Worcestershire Royal Hospital. Less urgent operations for fractures will be available at other sites, as now.
4. A paediatric assessment unit will be opened at the Alexandra Hospital and all children who need an overnight hospital stay will be treated at Worcestershire Royal Hospital.
5. The Redditch and Bromsgrove Commissioners will consider consulting on a new midwife-led unit in North Worcestershire and complex or higher risk deliveries will be at Worcestershire Royal where the maternity services will be expanded
6. The Trust and Commissioners with colleagues in the Health and Care Trust and other partners will redesign emergency departments, urgent care centres and minor injury units across the county in a model that has clinical support and in a way that the Trust and Commissioners believe is sustainable.
We fully recognise that we will need to have adequate capacity on each site if we are to achieve these steps.
As a result of these six steps our three hospital sites will be:
The Alexandra – a thriving hospital which continues to provide a wide range of hospital services for its local population. It will be a hub for elective orthopaedics, benign upper GI and urology surgery. We will be investing money in new theatres and equipment starting with the introduction of a mobile theatre later this spring which will enable some of the orthopaedic work currently undertaken at Worcester to move to the Alex. It will continue to have a busy medicine service.
Kidderminster Hospital and Treatment Centre – a thriving state-of-the art diagnostic and treatment centre with an increasing amount and range of daycase and short-stay surgery procedures. It will maintain its Minor Injuries Unit and we will seek to build on the work we have done with partners this winter to increase the number of patients it sees.
Worcestershire Royal Hospital – will be the centre for strokes, cardiac stenting, women’s and children’s services and most major cancer work. It will build on these specialities and ensure that all patients have access to high quality emergency care when they need it.
I will be expanding on our plans at a series of briefings for staff later this week. I do hope you will be able to attend one of the sessions outlined at the end of this letter.
We want to continue to work with you to develop our services and to listen to your views.
Chair Save the Alexandra Hospital Campaign