York MPs demand answers after damning report shows NHS struggling to hit targets

The report, due to be presented to the Vale of York Clinical Commissioning Group leaders next week, shows a series of missed targets for the ambulance service, A&E waiting times at York Hospital, planned care, diagnostics and some cancer referral waiting times.

The wide-ranging figures show Yorkshire Ambulance Service is still consistently missing targets to get to the most serious Red 1 medical emergencies, such as heart attacks and respiratory arrests, with 70.1 per cent reached in eight minutes in December - missing the target of 75 per cent.

And 84.5 per cent of suspected cancer referrals were seen in hospital within the required two weeks in November - missing the target of 93 per cent.

The target has been impacted by an increased volume of skin cancer referrals, the report notes.

>>> Read the report in full here

York’s MPs have expressed serious concerns about the report’s findings.

Sir Hugh Bayley , Labour MP for York Central, said: “This is very serious. Every missed target is a patient, or in most cases many patients, who are not getting the care they need from the National Health Service.

“York has dedicated, well-trained professional staff, but they are missing targets because the NHS in York is being starved of cash.

“This is exactly what happened when the Conservatives were last in power. Waiting lists and waiting times soared, and critical patient care targets were missed.

“The Labour Government put the NHS back on its feet, but standards of care are slipping badly again, and patients are suffering.

York MPs Sir Hugh Bayley and Julian Sturdy have voiced concern

“I spoke last week in the House of Commons to raise my concern about accident and emergency waits in York, poor ambulance response times and severe problems with mental health services in our area, but the Liberal Democrat Minister who replied to the debate did not respond to my urgent plea for action.

“The Government is in denial.

“These problems are the inevitable consequence of their cuts to NHS spending, at a time when the number of people needing care is growing because the population is ageing.

“We need increased funding, and better use of the health budget we already have.

“This is now very urgent. The Government should take urgent action.”

Other key figures from the report included that 72 per cent of ambulance handovers happened within the target of 15 minutes at York Hospital and 70 per cent at Scarborough Hospital.

Targets have been missed for handing patients over from ambulances to hospital staff

In December 2014, 86.5 per cent of A&E attendances were dealt with in four hours at the York Teaching Hospital NHS Foundation Trust, missing the target of 95 per cent, in what has already been reported as a difficult month for the trust.

Julian Sturdy, Conservative MP for York Outer, said: “I am deeply concerned by the Vale of York CCG’s failings highlighted in this report. Local health funding has been a problem ever since I came into office in 2010, but we must be clear that this is a CCG specific issue.

“I recently hosted a backbench debate in parliament on the current national health funding formula which is weighted towards deprivation rather than age and rurality, meaning areas like York are left with significant funding shortfalls.

“However, whilst continuing to bang the drum and campaign for fairer health funding for our area, we must be absolutely clear that NHS funding has been ring fenced in this parliament, and an extra £2 billion is being provided to the NHS in April.”

A spokeswoman for Vale of York CCG said: “The Clinical Commissioning Group is working very closely with its partners to identify appropriate ways to meet these targets.”

York's bed block crisis

NEW figures have revealed the extent of the problem of “bed blocking” in the York area, with nearly 11,000 bed days lost in nine months. Bed blocking in the York Teaching Hospital NHS Foundation Trust area was blamed for contributing to the recent crisis in A&E as there was nowhere for patients to go.

Over Christmas week alone 254 days worth of beds were lost at York Hospital due to bed blocking, at a time when the hospital was in crisis.

Delayed transfers of care happen when patients are ready to leave hospital or care but are not able to due to a lack of support or places to go to.

In England the majority of bed blocking delays are caused by the NHS, but in the York Hospital Trust area the majority are the responsibility of social services, a report due to be considered by York health commissioners reveals.

Sally Hutchinson, above, chief executive of Age UK York, said it was working closely with City of York Council to help elderly people ready to go home to free social services up to deal with patient with more complex needs.

She said: “Social services are trying to do a massive amount of work, having been cut for the last two or three years, people’s jobs are increasing on a daily basis and there are less people around to organise and deliver the care.

“They are working their socks off in a climate where cuts are rife and care packages tend to be bigger.”

From April to December, there were 5,062 days lost to bed blocking when it was deemed the responsibility of the NHS and 5,735 days lost when the responsibility was with social services.

In the York Hospital Trust area social services are responsible for 55 per cent of delays, compared to 26 per cent nationally, highlighting it as a particular problem in York.

Michelle Carrington, head of patient experience, will present the report to the Vale of York Clinical Commissioning Group governing body meeting on Wednesday.

The report says: “Over several months North Yorkshire County Council (NYCC) and the City of York Council (CYC) have been struggling to provide sufficient hours for re-ablement and home care.

"In November and December more than one provider gave notice to both councils to reduce the number of care hours available. This has impacted on delayed transfers of care and patient flow from both acute and non-acute beds.

“Equally we are still very much aware that although the trust have implemented their choice and discharge policy highlighting that patients fit for discharge should return home or to placement as quickly as possible, sometimes patients choose to remain in hospital whilst working through choice issues with regard to alternative placements, which can cause beds to be blocked for patients requiring admission.”

Age UK York said it has recently helped return 300 people ready to go home in the York area, helping to settle them by assisting with shopping.

Ms Hutchinson said: “I understand there are people who are waiting for a bed or are waiting for a care package at home and the most important thing is that person is in the best possible care at that time.”

She said the situation would be improved by the opening of two “super care homes” in York.

Seven City of York Council care homes are due to be replaced by new homes on the former Lowfield and Burnholme Community College sites at a previously reported projected construction cost of £25 million to £30 million but there have been delays in the programme and negotiations with providers have dragged into the new year.

The former Burnholme Community College, which is to be the site for a new care home which it is hoped will help replace seven existing ones

A council spokeswoman said it had made more beds available by introducing greater flexibility, maximising available beds and streamlining the move from hospital to residential care. She said the council was currently in daily contact with the hospital, which had proved successful.

The council said it had 225 residential care beds available but did not say what that figure would have been had its care-home shake-up progressed as planned.

She said the council had been given £325,000 from the Government to spend by March to reduce bed-blocking and said it was working with health partners and voluntary sector groups.

She said the grant had already included funding to support customers to ‘step down’ from hospital to private nursing placements, while they await longer term home care.

Guy Van Dichele, interim social care director, said: “Reducing delayed discharges is a priority for the city and we are continuing to do everything we can, in partnership with health and social care agencies across the city, to reduce delays in a safe and appropriate way.

“One of the key issues contributing to the delayed discharge situation is the significant number of older residents in the city, and particularly those over the age of 85, many of whom have complex health conditions.

"Another contributing factor is the strength of York’s labour market and the high percentage of highly skilled workers in the city. This means that private and public organisations can find it more difficult to recruit nursing and care staffthan in other parts of the country.”

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Parking perks could be among incentives offered to new job applicants

Perks considered to help fill roles

BOSSES at City of York Council are struggling to fill vital roles and are considering new perks and incentives to attract more applicants, writes Gavin Aitchison.

The authority has unfilled gaps in various areas including social care and bin collections.

Officials believe the city’s low unemployment rate means jobseekers in York can be more selective than in other cities, so are less inclined to seek low-paid jobs with the council.

They are now considering offering transport or housing perks or incentives to make the terms and conditions of social care jobs more appealing. Detailed proposals will be put to top managers within a month, with a view to introducing new incentives after May’s council elections. Ideas suggested include allowing new staff to park freely in council car parks, being provided with pool cars and given help to find housing.

Kersten England, the council’s chief executive, said precise costs were yet to be assessed, but suggested the council could spend in the region of £250,000 on making jobs more attractive.

Kersten England, City of York Council chief executive

She said recent bed-blocking problems at York Hospital had not been due to a lack of social care beds but a shortage of carers. She said that, like the private sector, the council was struggling to recruit.

The council declined to say how many unfilled posts it had or how many applications it typically received for such roles, compared to expectations, but a spokeswoman said the council had around 400 care assistants, home care workers, personal assistants, general assistants and support workers. She said turnover was “quite low”, with 35 leaving in the past year.

Two-thirds are paid in the region of £15,000 to £20,000 a year, pro rata.

Mrs England said: “We are looking at worker security, not just with the Living Wage but things like parking, transport and access to housing, because if you are on the Living Wage, even in this city, the cost of living is difficult.”

She said similar sweeteners had been offered in parts of London to attract teachers and social workers.

In recent weeks, York Hospital has been struggling under immense demand, partly fuelled by difficulties in discharging patients who need social care.

Mrs England told The Press: “Sometimes families do not want the place offered, and there can be issues of appropriate settings, but as much as that is the fact that sometimes we have not got the staff.”

She said the costs to the council could be countered by the savings to the health service, and said NHS bodies may be willing to contribute. She has called already for greater collaboration between councils and the NHS to enhance health and social care and ensure they work together and said society should re-evaluate the value it attached to social care, which remains a low-paid job.

Heather McKenzie, branch secretary and convenor of the Unison York City branch, said: “Care is definitely one of the sectors where there is a crisis in recruitment, and we would welcome any assistance that can be given to help with some of the things such as housing and transport.

Heather McKenzie, branch secretary and convenor of the Unison York City branch

“But what we would also want is for people to be paid a suitable rate for that job and for the extreme value of that work to be recognised, locally and nationally. As a society, we do not recognise the true value of that work, which is an absolutely vital service.”

A council spokeswoman said the council increased spending in adult social care by £2.5 million this financial year but said Government funding for such care had fallen by 26 per cent in four years.

Guy Van Dichele, interim director of adult social care, said reducing delayed discharges was a priority and the council was doing what it could.

He said the need for a dedicated and skilled workforce would continue to increase and said York’s voluntary sector was also vital.