Patients are now waiting nearly six hours in A&E at Birmingham hospitals as the medical situation ‘deteriorated’ over the past year, it has been revealed.
Increases in waiting times and agency staff spending were all discussed in a University Hospitals Birmingham (UHB) meeting last week week, as one top NHS chief claimed “green shoots” were starting to appear related to the Covid backlog.
A Council of Governors meeting heard four-hour waits had got worse at all hospitals under the management of UHB. The average time spent in A&E increased by 10.1% to 349 minutes in June, compared to 317 in May.
Admitted patients spent, on average, 596 minutes receiving treatment and non-admitted patients 254 minutes. Both figures showed a fall from figures recorded in May.
How does the wating times at University Hospitals Birmingham compare to the national target?
Four hour waiting times – the total time patients spend in A&E from the time they arrive to when they leave the department to be admitted, transferred or discharged – are set at a national target of 95%.
Current national performance is 72.1%, with UHB falling far below it. Good Hope hospital recorded a 57% A&E performance, while Heartlands hospital recorded 56.1%.
The overall UHB Trust recorded a performance of 53.2%. The lowest performer was Queen Elizabeth Hospital, with a rating of 46.4% at its major emergency department.
Ambulance breaches over 60 minutes totalled 2,037, in comparison to 1,686 in May. The number of breaches rose across all UHB hospitals with the highest increase seen at Good Hope hospital by 34.1%, followed by Heartlands hospital at 16.0% and Queen Elizabeth by 14.9%.
Critically, 4,336 patients spent more than 12 hours from time of arrival to leaving A&E, in comparison to 3,416 the previous month. All sites saw an increase in the number of 12 hour breaches with the highest increase seen at Good Hope Hospital by 81.6% since previous month.
Coronavirus numbers in Birmingham hospitals increased by 35% to 258 patients compared to 191 on May 31. Of the 258, 208 were “active” with coronavirus. Seven patients were recorded in critical care units compared to only one at the end of May.
What have the Council of Governors advised to help ease ease these wating times?
The UHB Council of Governors report said: “The Trust has reviewed its Infection Prevention and Control (IPC) measures. Universal mask wearing is to return in all UHB hospitals and community clinic settings. Staff and visitors are advised to wear a mask in all clinical and non-clinical areas. Patients will also be encouraged to wear a mask, where they can be tolerated.
“Visiting restrictions have been eased allowing one visitor a day with a new timeframe of 11am-7pm for any length of time. The impact of the change is being closely monitored to ensure staff and patients remain safe whilst supporting patients’ wellbeing.”
It was also revealed 1,034 patients were waiting for 62 days, for treatment related to endoscopy and urology, but governors claimed during the meeting hospitals across UHB were treating more cancer patient than pre-pandemic.
What has the UHB Chief Financial Officer said about the report?
Julian Miller, Chief Financial Officer, at UHB said: “It’s been an extremely challenging few months since the last public board. We have done a lot to return to the elective care programme. We’ve altered and concentrated on our quality and safety issues around the place.
“Up until recently, we’ve had rising numbers of Covid positive indications. That’s starting to come down. Despite the efforts of our stretch style, there are too many patients waiting longer than we and they would like whether in the community, or in an ambulance, for their procedure, or an outpatient appointment.
“I’d like to hope I think there are some green shoots appearing. I’d like to hope that we can demonstrate that.”
Have there been any issues with staff absences?
Agency staff expenditure amounted to £3.9 million or 4% of total pay expenditure, which is £83 million a significant rise above UHB’s agency budget. The report also showed a significant increase in staff absences due to “psychological causes”.
Sandra Haynes MBE, a public governor, asked how agency staff spends would be compounded by the financial crisis.
Mr Miller claimed the cap shown in the reports were from last year, but added it was “going to be hard to rein it in significantly”. He said: “There are certainly big vacancies the Women’s Children’s Hospital, which have been covered by agency and similarly, I think in the Mental Health Trust, so it’s going to be a challenge in the whole system.
“Ultimately, the success in terms of the recruitment and retention initiatives is going to determine the pace at which we can try and start reducing our reliance on external agency.
“We’re going to have to make sure our staff can be replaced. It will help us if we can get past this current wave of Covid so we can start to see sickness absence come back down. We’ve got changes nationally to arrangements around long Covid sick pay being received for that which will start to increase our staff availability.”
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