Harrogate knee surgeon’s breakthrough gains national interest

A digital report developed by a Harrogate surgeon is attracting national interest.

Patients undergoing knee surgery at Harrogate and District NHS Foundation Trust are now able to benefit from a bespoke digital report, designed to improve understanding of their treatment and reduce any unnecessary outpatient appointments.

The creation of the report comes after nearly 25% of knee arthroscopy patients claimed they were not alert enough to discuss their surgery in the post-operation period.

Three quarters of those surveyed also claimed they were unable to recall post-operation instructions, such as weight bearing advice, meaning over half of the patients required further appointments to aid their understanding.

Dave Duffy, a consultant trauma and orthopaedic surgeon at HDFT, used the Arthrex Synergy Surgeon app to devise a video that walks patients through the procedure step-by-step, as well as an audio explanation to ensure full accessibility and understanding of the treatment.

The patient is also provided with an in-depth explanation of the next steps in their recovery, from bandaging wounds to appropriate exercises.

Since the introduction of Mr Duffy’s solution only 15% of patients that received the digital report felt they needed further appointments.

He said:

“The report puts patients’ minds at ease, provides answers to many of their questions, and in many cases removes the need for further appointments or written communications, allowing the clinician to spend additional time helping other patients.

Transforming outpatient services remains a key part of the NHS Long Term Plan, with Mr Duffy’s digital report playing an increasingly significant role in doing so.

He added:

“We have received lots of enquiries about the innovation from other partners in the NHS and we are keen to share our learning to scale up the innovation for the benefits of patients.”

Dr Jacqueline Andrews, medical director and executive lead for digital at HDFT said:

“Our trust’s strategy puts healthcare innovation at the heart of everything we do. Our purpose is to improve the health and wellbeing of our patients, children and communities, and digital transformation plays an important role in this.

“We want to invest in digital tools and services which makes it easier to provide the best quality, safest care and improves the experience for our patients. As a relatively small trust we have the ability to be agile when it comes to innovation, rapidly piloting new innovations and gaining feedback fast, for the benefits of healthcare innovation businesses and the NHS.”

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Harrogate hospital appointments rearranged after CT scanner breakdown

Harrogate hospital has been forced to rearrange 76 scan appointments after one of its CT scanners broke down.

Patients due appointments this past week were either told their scans were rearranged or referred to Leeds.

Officials at Harrogate and District NHS Foundation Trust said the scanner had “a number of breakdowns”  over the last four weeks, each of which left it non-operational for up to two days.

CT scans create detailed images of inside the body which can identify issues such as tumours.

In total, 76 patients had their non-urgent appointments rearranged and 41 who required urgent scans were sent to Leeds.

Hospital managers say the scanner has since been repaired and will be replaced in June.

A spokesperson for the hospital trust said:

“Over the last four weeks, one of the machines has experienced a number of breakdowns, each lasting one or two days. This has unfortunately meant that some non-urgent scans have needed to be re-arranged, which we have done so as a priority.

“The health and safety of our patients is our primary concern and those people needing urgent scans during the periods in which our CT scanner was not working, were transferred to hospitals in Leeds to ensure their scan could take place.

“The scanner has now been repaired. By early June, a new CT scanner will be installed at Harrogate District Hospital, which will work alongside our other CT scanners, ensuring we have additional resilience in the future.

“We are committed to providing the best possible healthcare service for our community and over the next few years, we are investing around £3 million in our imaging department to provide new digital x-ray and CT scanners. This will further improve on the service we provide and significantly reduce waiting times for patients.”

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Hard up Harrogate hospital staff sell back 2,000 days off in six months

Staff at Harrogate District Hospital sold back almost 2,000 days off that they were entitled to in just six months, figures reveal.

Harrogate and District NHS Foundation Trust, which runs the hospital, introduced a policy last year where staff could ‘sell’ time off they had accrued back to the trust in order to receive extra money in their pay packets.

It was hoped the move would ease the financial burden that many staff have been under throughout winter as the cost-of-living crisis deepened.

At the time, chief executive Jonathan Coulter even said the finances of some people working for the trust were putting them under more stress than the benefit of having a holiday.

The policy, which has now closed, was capped at a maximum of five days off sold per employee.

The Local Democracy Reporting Service sent a freedom of information request to the trust, which employs around 3,500 people, asking how many staff had taken the trust up on its offer.

The figures show that between September 2022 and March 2023, 492 employees sold back 14,480 hours.

If this were divided into seven-and-a-half hour shifts, it equates to around 1,800 individual days off sold.

Harrogate hospital

Since the policy was introduced in September, members of health unions have gone on strike over low pay, which they argue is compromising patient safety and leading to an exodus of trained professionals from the NHS.

Ben Kirkham, GMB Union regional organiser, said the move by the trust to let staff sell days off is exacerbating staff burnout and sickness. He added:

“The NHS is suffering from chronic underfunding and a major crisis in staffing, resulting in huge appointment and operation back logs.

“For both staff and patients its vital that the NHS is funded properly and that means urgent investment.”

A Royal College of Nursing spokesperson said:

“RCN members are caught between twin crises. The cost-of-living crisis in which selling annual leave is one method of making ends meet and the staffing crisis. Nursing staff are already required to work significant levels of unpaid overtime to support increasingly unsafe levels of staffing across many health and care settings.”

‘Help staff with their money worries’

A Harrogate and District NHS Foundation Trust spokesperson said:

“Last year, as a consequence of the cost of living crisis and the pressures faced by our staff due to spiralling day-to-day costs, we introduced a cost of living package providing a wide range of support to help colleagues who were struggling.

“The support included financial aid in the form of a hardship grant, general help, advice and resources on financial and mental wellbeing, and for the first time, the opportunity for staff to sell up to five days of their holiday entitlement during 2022/23 financial year.

“Whilst we encourage colleagues to take their annual leave as it enables our minds and bodies to rest and recuperate, we felt that the option for staff to sell some of their annual leave would be appreciated as it would provide a further opportunity to help them with their money worries.

“The scheme ran until the end of March this year and we were pleased to support 492 colleagues who chose to sell some of their annual leave.

“Our staff are our greatest asset and it is important that we support them in these challenging times. Our range of support for staff continues to develop and we will look at introducing further means of support for our staff in the future.”

Interim leader of Harrogate hospital given permanent role

The interim chief executive of Harrogate and District NHS Foundation Trust has been appointed to the post permanently, the hospital has announced.

Jonathan Coulter has held the post on a temporary basis previous chief executive Steve Russell went on secondment as national director for vaccines and screening with NHS England last February.

His move was made permanent in December, after which HDFT began recruiting nationally for a replacement. HDFT chair Sarah Armstrong said:

“I am delighted Jonathan has been appointed to the role of chief executive and I know he will lead the organisation with care, dedication and commitment.

“This is an exciting time for our trust. We are committed to providing the best possible level of healthcare for our community and we have a number of exciting projects over the next few years which will further improve on the high quality health and wellbeing service we provide.

“Jonathan’s knowledge and experience will be invaluable in driving these projects forward and I am very much looking forward to working closely with him in the future.”

Mr Coulter has worked in the NHS for more than 30 years, of which 20 have been as a director. He became finance director at HDFT in March 2006 before being appointed deputy chief executive four years later.

He said:

“I am delighted to have been appointed permanently into the role of chief executive.

“HDFT is a brilliant organisation with wonderful people. It is very humbling to be in a position to support all of our fantastic colleagues to be the best that they can be, and continue to do what we try to do every day, which is to help and support the people who need us.”

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Harrogate hospital food rated worst in country by patients

Hospital food in Harrogate is the worst in the country, according to patients.

Harrogate and District NHS Foundation Trust received the lowest rating of all the hospital trusts assessed in the NHS survey.

Patients awarded the trust, which runs Harrogate District Hospital, 72% for food quality.

The next lowest was Mid-Cheshire Hospitals NHS Foundation Trust with 74%, closely followed by York and Scarborough Teaching Hospitals NHS Foundation Trust.

Private provider Bupa rated the highest with 100%.

NHS Digital published the figures as part of its 2022 Patient-Led Assessments of the Care Environment programme.

PLACE assessments are an annual appraisal of the non-clinical aspects of NHS and independent/private healthcare settings.

Harrogate fared better on cleanliness, ranking 53rd of the 222 organisations with a score of 99.49%.

But it was a lowly 192nd on privacy, dignity and wellbeing with a score of 81%.

Hospital issues apology

A Harrogate and District NHS Foundation Trust spokesperson said:

“We strive to provide the best possible levels of service for those people in our care and we are extremely disappointed that we were unable to meet the expectations of our patients when the assessment took place.

“We would like to apologise to anyone who has been dissatisfied by the service we provided.

“It is important that we learn lessons from these findings as food is an important part of a patient’s hospital experience. The quality of food provided to our patients has always been high, but there is the opportunity to improve on the levels of service.

“We take such assessments extremely seriously and have already started to make improvements to address the concerns that have been raised.”

“These improvements have already had a significant impact and we will continue to make further changes to ensure we are meeting our patients’ expectations.”

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Harrogate district amateur dramatic group stripped down and raised £12,000

A Harrogate district amateur dramatic group who bared all in a production of Calendar Girls raised £12,000 for three cancer charities.

The Kirkby Overblow Dramatic Society performed its own version of the Tim Firth film late last year.

All proceeds from the play have been donated to the Sir Robert Ogden Macmillan Centre at Harrogate District Hospital, Maggie’s Yorkshire and Blood Cancer UK – each of which received £4,000.

The sell-out show was “the most successful charitable performance we have produced”, according to the chairman.

The 1999 film is based on a true story of how Rylstone and District Women’s Institute, near Skipton, posed for a nude calendar to raise money for leukaemia cancer.

The cast also took part in their very own nude photoshoot – posing strategically at local landmarks in the village.

Photo: Annette Fishburn Photography

Claire Mackenzie, director of the production, said:

“When I was asked to choose a play which we could put on, I was thinking more about what we could take off, this way it would be an attention grabber…and it worked, thanks to the commitment and bravado of all the cast and crew”.

Cast and crew of Calendar Girls handing over the cheque donations to three cancer charities.

Regional fundraising members for the charities were on hand to accept the money raised by the dramatic society.

Fiona Gavaghan, of Macmillan Cancer Support, said:

“Huge thanks and congratulations go to the KODS team for raising this astounding amount.

“What they have done will change the lives of hundreds of cancer sufferers and their families throughout Yorkshire”.

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Harrogate hospital pays six-figure sum to patient left severely disabled

Harrogate and District NHS Foundation Trust has paid a six-figure sum to a patient who suffered a stoke and cardiac arrest after an operation, leaving him severely disabled.

The trust and York and Scarborough Teaching Hospital NHS Foundation Trust were found jointly responsible for the treatment of the 74-year-old patient, who suffered a minor stroke in January 2016.

Having developed some slurring of speech and a headache, he was taken to Harrogate District Hospital by ambulance, where he was admitted to the stroke unit and underwent a CT scan of the head.

As part of the legal case against the two trusts, solicitors acting on behalf of the man made several allegations of negligence. It was alleged imaging was wrongly reported and surgery was unnecessarily performed.

During the surgery the patient suffered a stroke and later a cardiac arrest from which he was successfully resuscitated.  He was left severely disabled and brain damaged.

Solicitor Elizabeth Maliakal, a specialist in medical negligence claims at Hudgell Solicitors, led the legal case on behalf of the patient, whose daughter was appointed his deputy by the Court of Protection to manage her father’s affairs.

Ms Maliakal alleged the operation had been carried out without the patient or his family being fully informed of the risks involved, and without being informed that the benefits of surgery were small. She said the case centred on two key aspects of care and treatment:

“Firstly, there was no need for surgical intervention and, had my client not undergone surgery, he would have avoided the stroke which occurred during surgery and the later cardiac arrest.

“Secondly, he was inadequately consented over the decision to operate and, given doubts about his mental capacity to consent, his family were not consulted over the decision either.

“Had an appropriate discussion taken place regarding the relative risks and benefits, neither my client nor his family would have consented.

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elizabeth maliakal hudgell-solicitors

Ms Maliakal (pictured above) added:

“Whilst our medical experts felt that he may well have gone on to suffer further strokes in the near future, had he not undergone the surgery, they were of the opinion that he would not have been left as profoundly disabled as he is now.

“He has been left with a catastrophic injury.  He is paralysed, has little vision in his right eye and reduced vision in his left eye. He is unable to talk, he is doubly incontinent, needs to be fed through a tube and requires hoists to be moved.  He now lives permanently in a nursing home.”

‘Denied liability’

Harrogate and District NHS Foundation Trust and York Teaching Hospital NHS Foundation Trust agreed a six-figure sum for damages. The precise amount has not been revealed.

The compensation agreed covers the cost of future care, nursing home fees, private medical treatment, medication expenses and aids and equipment.

Mrs Maliakal added:

“This was a hard fought case. Initially both trusts denied liability and it was only after court proceedings were commenced that settlement discussions took place. The negligent treatment left my client severely disabled, and in need of round the clock care, which could and should have been avoided.

“As part of our investigations into the case we instructed independent medical experts, including a vascular surgeon, a stroke physician and neuroradiologist. The Trusts agreed to compensate

A joint statement for Harrogate and District NHS Foundation Trust and York and Scarborough Teaching Hospitals NHS Foundation Trust, said:

“The trusts sincerely regret the difficulties experienced by the claimant and are pleased to have been able to reach an amicable compromise of his claim.  The trusts wish the claimant and his family well for the future.”

First ever nurses’ strike begins at Harrogate hospital

Nurses at Harrogate District Hospital have gone on strike today for the first time ever.

A picket line is in place outside the hospital on Lancaster Park Road for the first of two 12-hour strikes called by the Royal College of Nursing.

Surgical nurses, paediatric nurses and accident and emergency nurses were among those taking part in this morning’s industrial action. Some passing vehicles sounded their horns in support of the strikers.

Amanda Brown and Andy Law, RCN officers from Leeds who joined Harrogate nurses on the picket line this morning, told the Stray Ferret the action was necessary because the NHS is “broken”.

Mr Law added the NHS was short of 47,000 nurses — up by 7,000 on a year ago.

Although the strike will disrupt some services for patients, Ms Brown said people requiring urgent care would not be affected:

“We’ve ensured staffing levels are safe.”

Today’s action is the latest wave of industrial action in the Harrogate district. Ambulance workers, rail workers and postal workers have all been on strike this winter.

Pat Cullen, the RCN’s general secretary and chief executive, has warned the strikes could escalate in the weeks ahead if a settlement isn’t reached.

Health Secretary Steve Barclay has said “unaffordable” pay rises for nurses would prevent investment in the NHS.

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Harrogate hospital ‘almost completely full on a daily basis’

Harrogate District Hospital is ‘almost completely full on a daily basis” and has urged patients’ families to help free beds.

Hospital officials appealed for help today amid growing concerns about the NHS’ ability to cope with winter pressures.

More than a dozen NHS trusts and ambulance services declared critical incidents over the festive period. Dr Adrian Boyle, president of the Royal College of Emergency Medicine, has said up to 500 people could be dying each week because of delays to emergency care.

Harrogate and District NHS Foundation Trust has not declared a critical incident but a spokesman said 50 patients were currently unable to leave because they were waiting to be allocated care or a placement.

This bed-blocking was compounding “significant pressure due to the number of people requiring our help and the challenges of a difficult winter”, the spokesman said.

He added:

“Over bank holidays, our emergency department is usually busier than normal, and this has been the case over the period since Christmas.

“Our hospital is also affected by the high numbers of covid and flu patients we are currently caring for. These patients often require a longer stay in hospital before they can return to care or residential homes.

“This, in addition to around 50 patients who are waiting to have care or a placement allocated so they can leave our hospital, means Harrogate District Hospital is almost completely full on a daily basis.”

Emergency department at Harrogate District Hospital.

The emergency department at Harrogate District Hospital.

The spokesman said this was leading to “long waits for beds to become available” and visitors with less urgent issues experiencing longer waiting times.

He added:

“We do know that when patients are starting to improve and no longer require hospital care, the remainder of their recovery happens much quicker in their own homes.

“We would ask for the families of patients to help us support their loved one’s discharge home as soon as their medical condition allows.

“Some patients may be fit to be discharged to their own home, but still require additional support to help them in their recovery. Our teams will work with patients and their families to support them as best we can.”

The spokesman also appealed to families to show understanding if the hospital had to return care home patients to different care homes for short periods.

He reiterated the message to only visit the emergency department for life-threatening or severe illnesses or injuries.

 

‘Lessons learned’ after covid patient’s oxygen disconnected at Harrogate hospital, inquest hears

Harrogate hospital has “learned lessons” following the death of a woman who became disconnected from her ventilator when she was left alone in a room with the door closed.

Karen Smith was 44 when, in October 2020, she was admitted to the hospital with covid.

She was put on a temporary intensive care ward that had been set up by Harrogate and District NHS Foundation Trust to deal with the high demand of the pandemic.

An inquest heard this week Ms Smith died on the ward after her oxygen mask became disconnected.

The continuous positive airway pressure (CPAP) oxygen machines used on the ward were not connected to the nurses’ station in the way they were on the established ICU.

When Ms Smith’s mask came off and the tube became disconnected around 5am on Saturday, October 24, although the machine’s alarm sounded, there was no way of it sending a signal to the nurses’ station for a rapid response.

The previous day, the hospital’s infection control team had visited the ward and recommended that the doors to each bay, which had been open, should be closed to help reduce the spread of covid.

Dr David Earl, a consultant in anaesthesia and critical care, told the inquest:

“The doors were closed on that Friday and I don’t think enough work was done to recognise the implications of how that might make nursing quite difficult, because you can’t hear behind the doors.

“This is when things start to go a bit wrong, I think, on that Friday.”

On the Saturday evening, a nurse who was covering a meal break had left Miss Smith’s bay to go to the toilet urgently. She had no way of contacting another nurse to cover for her, but believed the original nurse was about to return from her break.

The inquest heard that, during the pandemic, staff were required to remove extensive personal protective equipment (PPE) and go to a bathroom nearby, rather than the one on the ward, which took much longer than usual.

When the nurse she was covering for returned, the disconnection was noticed and Ms Smith’s mask had been completely removed.

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Dr Earl told the inquest many patients find CPAP masks uncomfortable and can attempt to remove them when slightly disorientated, such as when waking up.

The machine’s log indicated Ms Smith had been without hers for around four-and-a-half minutes. A new mask was immediately brought from the store cupboard nearby.

Staff said they hoped the short time of disconnection meant that Ms Smith would not have been affected by the lack of oxygen supply.

The inquest heard that, although her blood oxygen levels quickly rose again, it became apparent to the team on the next shift that she was more sleepy and less responsive than usual.

That night, as her condition further deteriorated, staff called her mother, but she was not allowed to come into the hospital because of covid restrictions.

Addressing Ms Smith’s mother Audrey and brother John, who were at the inquest, Dr Earl said:

“At the time, we were following national guidelines about visiting.

“As someone who worked through all of this, not having visitors all the time was terrible. On intensive care, we spend a lot of time with families getting to know them. To suddenly not have families there was absolutely awful for us, but we know it was even worse for families like yourselves.

“It we could go back, we would get you straight in when we knew [she was dying]. Now, that’s the national guidelines.”

Ms Smith said her daughter had been well enough the day before to be messaging her friends. However, Dr Earl said given the number of days she had been reliant on the CPAP without any sign of improvement, his experience with covid patients suggested she was more likely than not to have succumbed to the virus in the end.

Walkie-talkies introduced

Dr Earl said the hospital had “learned lessons” from Ms Smith’s death and a number of changes had been implemented to prevent the same situation arising again, including changes to nurse rostering and the introduction of walkie-talkies to allow nurses to communicate with each other even when in separate rooms.

He added:

“We realise we can’t make everything perfect, but we try to list all the things where we think there’s a potential danger there and try to minimise them.

“In this new area, we had one of those risk registers and recognised it was constantly evolving, but in these circumstances, it was the best we could do.”

Delivering a narrative conclusion, senior coroner for North Yorkshire Jonathan Heath said Ms Smith, who lived in Wetherby, had died from a hypoxic brain injury caused by becoming disconnected from her oxygen machine. A secondary cause of death was her high body mass index.

Mr Heath said there was no evidence of how Ms Smith’s mask came to be removed and the tube disconnected, so he did not want to make any assumption.

Mr Heath said:

“I am satisfied that a ‘prevention of future deaths’ report is not required.

“Whatever I would be saying to the hospital appears to have been addressed already.”