How do we solve the NHS crisis in Peterborough?

The NHS in Peterborough is currently in crisis.

Sunday, 2nd February 2020, 5:00 am

Poor A&E waiting times, long delays for ambulances and rising demand on services - mirroring the national picture - means hard-working staff are increasingly being faced with an impossible job.

To try to understand why the problems are so bad, and how they can be fixed, the Peterborough Telegraph spoke to leading health figures and politicians to get their views.

A&E

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A photo of stacked ambulances at Peterborough City Hospital late last year

Hospitals are expected to admit, treat or discharge 95 per cent of patients within four hours of arrival.

But at Peterborough City Hospital that figure has plunged to 56 per cent with chief executive Caroline Walker admitting the figure was “unacceptable”.

Some of the reasons are nothing new, with rising populations, people visiting A&E for what health chiefs would class as non-emergencies, delayed transfers of care (commonly known as bed blocking), as well as a shortage of available beds at the hospital.

One example of a faltering system came from the Alzheimer’s Society last week when it revealed that there were 1,300 ‘unnecessary’ admissions of dementia patients in 2017/18 - a rise of 67 per cent in five years - due to what it describes as a “collapsing social care system”.

Graham Wilde, chief operating officer at North West Anglia NHS Foundation Trust, which runs, Peterborough, Hinchingbrooke and Stamford and Rutland hospitals, said the number of patients attending the Emergency Departments at Peterborough and Hinchingbrooke has grown by 1,223 over the past year.

“Increased levels of attendances, greater acuity of patients and higher levels of staff sickness have all played a part in our performance, falling short of the 95 per cent four-hour waiting time standard,” he admitted.

The Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) - which is responsible for planning and buying local NHS services - said NHS England had allocated £965,000 of winter funds to the trust to “help improve patient flow and timely discharge from hospital and avoid ambulance handover delays”.

A spokesperson added that there would be a “more joined up” approach between local health bodies which will be “responsive to the needs of our local people, as well as using our limited resources better”.

Samantha Hemraj, a Labour city councillor who works for the NHS, said: “Ten years of austerity and cuts have impacted on the ability of the NHS in general to meet targets set. 

“There is increased use of A&E because more and more people are struggling to get a GP’s appointment and they’re using A&E as a default. This issue is further exacerbated by savage cuts to social care funding which means those who need assistance when they leave hospital aren’t getting it.”

Cllr Hemraj also raised the issue of GP practices being pushed to join primary care networks (where they are grouped together) which she claimed is leading to GPs resigning. The funding for the networks could be better used by hospital trusts, she added.

However, the CCG defended the use of primary care networks which it claimed “provides patients with joined up services, improved access and a strong focus on prevention and personalised care”.

Money is always at the heart of the argument over the NHS, with the hospital trust and CCG both having to tackle multi-million pound deficits, and the latter acknowledging that resources locally are “limited” due to underfunding compared to other areas.

But, North West Cambridgeshire MP Shailesh Vara is adamant new money coming from the Government will make a difference.

He said: “We need to look carefully at the reasons for the shortfalls to see what improvements can be made, and in the meantime, the proposed record funding increase to the NHS of £34 billion should go some way to helping to alleviate the problem.”

MP for Peterborough, Paul Bristow, also focused on the NHS in his maiden speech in Parliament.

He called for more NHS funding, but also highlighted the need for a “culture change” with “more timely access to medicines and health technology (which) could transform the service for patients”.

Despite the challenges, improvements are being made in Peterborough. Mr Wilde outlined a number of initiatives including opening additional beds, increasing staffing levels and building a new ambulance off-load area.

A new service currently being piloted at Hinchingbrooke - where patients are assessed by a registered nurse or paramedic at the front door of the Emergency Department, with some redirected - will be rolled out in Peterborough if successful.

Ambulance delays

The East of England Ambulance Service has had its fair share of negative headlines, after stories of patients being left waiting for hours to be picked up. On top of that, the number of hours lost from handing over patients at Peterborough City Hospital hit nearly 850 in December.

Last July, inspectors gave the service a rating of “Requires Improvement” due to it not having enough staff to keep patients safe.

This was just five months after a risk summit was co-hosted by NHS Improvement and NHS England following concerns over the strain on the service, leading to a seven point action plan being agreed. Despite claims of improvements the latest figures show response times are below the England average for all categories of incidents.

This includes the most serious calls (known as Category One) where on average an ambulance should arrive within seven minutes. In December, the average for the ambulance service was eight minutes 25 seconds - the second worst in the country.

Luke Squibb, head of operations for Cambridgeshire and Peterborough ambulance service, said recently there have been improved handover times and that the challenges are “not unique” to the city hospital. Highlighting improved staffing levels as a recent improvement, he added: “Training and development of our frontline workforce in Peterborough is enabling our crews to treat more patients in the community without the need for them to be conveyed to an emergency department, with a continual increase in patients being successfully treated over the phone by experienced clinicians within our operations centres.”