The trust that runs York Hospital remains under “extreme” pressure, with staff shortages and an inability to discharge patients into the community the biggest concerns as winter approaches.
Nearly a third of ambulance transfers to York and Scarborough emergency departments took more than an hour in August, while 924 tram waits of more than 12 hours were reported.
Tram waits, the time between when a doctor decides a patient should be admitted to hospital for further treatment and when the patient is actually admitted, were almost unheard of before the pandemic at this length.
At a York and Scarborough Teaching Hospitals NHS Foundation Trust board meeting on Wednesday, interim COO Melanie Liley explained that 30 beds at York Hospital were closing so that the “fundamentals of care” could be provided with the level of staff available.
This was a requirement after the Care Quality Commission (CQC) raised concerns about the standard of care earlier this year.
Another inspection is expected before Christmas, but hospital board documents noted that “continued complaints and investigations by staff do not inspire confidence with the external regulator and may instigate a broader inspection.”
Eight reporting concerns raised by staff this year, primarily about staffing at York Hospital, have been upheld by the trust itself.
But trust chairman Alan Downey said improvements were being made.
“It seems to me that we are seeing significant measurable change in some of the things that we needed to change to convince the CQC that we are making progress,” he said.
Delayed discharges a ‘huge’ problem
Regarding the flow of patients through the hospital, the meeting heard that York now had a 24/7 emergency assessment unit and that the Yorkshire Ambulance Service had agreed to station paramedics within the hospital to try to stop the buildup of ambulance queues while patients wait. be admitted
Ms Liley said working with York City Council and North Yorkshire County Council to find ongoing care for people who no longer need to be in hospital remained a challenge.
The trust is even considering setting up its own home care service to care for people once they have left the hospital.
Hospital chief executive Simon Morritt said the scale of late discharges was “huge”, with 120 people waiting to leave York Hospital.
Morritt explained that the trust could expect to get £5m of the £500m announced by health secretary Therese Coffey last week to fund discharges of medically fit patients.
Head Nurse Heather McNair explained that a nursing shortage was one of the biggest staffing issues, with more than 100 vacancies. She said the prospect of a full complement of nursing staff, fueled by international recruitment, was still a year away.
The most recent futures show the trust spent £20m in one year on agency staff, making it one of the biggest spenders on temporary staff in the region.
However, the trust has been successful in hiring health care assistants and patient service agents in recent months.