Hospital managers in Harrogate have raised concern over the sustainability of taking in ambulance patients from York.
In a report due before a Harrogate and District NHS Foundation Trust board meeting, Jonathan Coulter, chief executive of the trust, said the issue was having an impact on both patient safety and staff at Harrogate District Hospital.
Mr Coulter said Harrogate had taken in more than 1,500 ambulances from York over the last 18 months.
He said:
“In the spirit of challenge and improvement, we have raised our concerns about the sustainability of the current situation, in particular the impact on patient safety and the impact on colleagues.”
Under a previous agreement, the hospital took in ambulances which had been diverted away from York Hospital during times when the organisation’s emergency department was under pressure.
Harrogate took in patients in an “ad-hoc” manner, meaning that ambulances would request support from hospitals which had the capacity at any given time.
Read more:
The trust agreed with Yorkshire Ambulance Service and York and Scarborough Teaching Hospitals NHS Foundation Trust to amend the agreement in May 2023 and redraw the boundaries between the two hospitals and to take patients in a “planned way”.
However, in a statement to the Stray Ferret, the trust said it still receives ad-hoc requests from ambulances some four months later.
A spokesperson said:
“Following a constructive review with both Yorkshire Ambulance Service and York and Scarborough Teaching Hospitals NHS Foundation Trust, in May 2023 we agreed to redraw the geographical boundaries between hospitals in Harrogate and York. Ambulances that previously would have gone to York now come to Harrogate, but in a planned, rather than ad-hoc way.
“Despite this new arrangement, there is still significant pressure across our health system and we continue to receive ad-hoc requests to divert ambulances to Harrogate.
“Providing the best possible healthcare for people who need our help is our main priority and we are in discussions with system partners to see what solutions can be introduced to alleviate pressures before we enter the winter period.”
Members of the hospital trust board will discuss the report at a meeting on Wednesday (September 27).
Interim leader of Harrogate hospital given permanent roleThe 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.”
Read more:
- Sharp rise in overseas nurses recruited at Harrogate hospital
- Harrogate hospital advertises for new chief executive
Harrogate hospital advertises for new chief executive
Harrogate and District NHS Foundation Trust is advertising for a new chief executive.
Steve Russell left the role last year to take up a secondment at NHS England as director for covid and flu vaccinations.
In December, it was confirmed Mr Russel had taken up a position as director of vaccination and screening permanently and would not be returning to Harrogate.
The trust, which runs both Harrogate District Hospital and Ripon Community Hospital, has been overseen by acting chief executive Jonathan Coulter since February 2022.
A notice on the trust’s website advertising the role closes on April 26 with interviews due to take place on May 10 and 11.
No details of salary is included. However, Mr Coulter is paid a salary of £181,000.
Read more:
- Harrogate hospital chief will not return from NHS secondment
- Harrogate hospital employs security staff for first time
- Inspectors says Harrogate hospital maternity services ‘requires improvement’
The role requires a candidate to have five years’ experience at board or director level and to ensure the trust’s services are “safe, effective, caring, responsive and well led”.
The move to appoint a new chief executive comes as the trust tackles long waiting lists, A&E waiting times and junior doctors strikes.
Last month, the Care Quality Commission also rated Harrogate hospital’s maternity services as “requires improvement”.
However, Mr Coulter said the rating was “not a fair reflection” of the service.
Harrogate hospital chief will not return from NHS secondmentSteve Russell will not return to his role as Harrogate and District NHS Foundation Trust (HDFT) chief executive after accepting a national director position with NHS England.
In February, Mr Russell left his role in Harrogate to take up a secondment as national director for covid and flu vaccinations at NHS England.
The secondment was due to last up to a year but he has now been offered a permanent role as director of vaccination and screening.
HDFT chair Sarah Armstrong thanked Mr Russell for his efforts at a HDFT board of directors meeting in Harrogate on Wednesday.
A HDFT spokesperson added:
“We would like to warmly congratulate Steve and wish him every success in the future.
“In the meantime, the current executive team arrangements will continue to operate whilst we consider what the permanent arrangement will be.”
Read more:
- 500 Harrogate hospital staff apply for cost-of-living hardship fund
- Harrogate hospital employs security staff for first time
Mr Russell was appointed chief executive in April 2019 and was in charge of the trust during the peak of the Covid-19 pandemic.
He also led the organisation during the creation of an NHS Nightingale hospital at Harrogate Convention Centre. The hospital closed last year without treating any Covid-19 patients.
Jonathan Coulter has been working as HDFT chief executive since February and will continue in the role until a permanent appointment is made. He is paid a salary of £181,000.
Mr Coulter is a qualified accountant and has taken on a number of roles at various hospital trusts.
He joined HDFT as finance director in March 2006 and has also worked as deputy chief executive.
500 Harrogate hospital staff apply for cost-of-living hardship fundAround 500 Harrogate District Hospital staff have applied for a cost-of-living hardship fund, which has been described as a “signal” of the financial pressure that healthcare workers are under.
Anyone employed by Harrogate and District NHS Foundation Trust (HDFT) or Harrogate Integrated Facilities (HIF) is eligible to apply for a one-off £500 payment. A panel meets each week to consider applications.
The number of people who have applied for the payment was revealed yesterday by HDFT acting chief executive Jonathan Coulter at the trust’s monthly board of directors meeting in Harrogate.
Between HDFT and HIF, there are around 5,000 staff, with the number of hardship fund applications indicating around 10% are currently struggling financially due to increased fuel, food and energy costs.
Mr Coulter said:
“It is a signal of some of the difficulties some of our colleagues are under in terms of the national situation. We will continue to watch out for those people.”
Other initiatives available for staff include being able to sell holiday entitlements to earn extra money. The trust also advises how to use food banks and provides information on managing finances.
Read more:
- No walkout at Harrogate hospital as part of nurses strike
- Women live 10 years longer in Harrogate than Knaresborough, report shows
- Harrogate hospital pledges ‘minimal disruption’ as nurses’ strike looms
At a meeting in September, Wallace Sampson, hospital trust board member and chief executive of Harrogate Borough Council, said he had “mixed feelings” about staff being able to sell annual leave as he believes it is “very much needed” to help with their wellbeing.
The number of staff struggling to make ends meet comes at a time when nurses are preparing to strike for the first time in over 100 years.
The Royal College of Nursing (RCN) is asking for a 19% pay rise but the government says this is unaffordable.
Harrogate members of the RCN voted to strike but Mr Coulter said that Harrogate is not on the list for the first wave of action on December 15th and December 20th.
Mr Coulter added:
1,300 people waiting a year for operations at Harrogate hospital, says chief executive“We will continue to support colleagues and support trade unions.
“It’s important that we do value our colleagues in terms of national negotiations or pay awards and we recognise the link between how people feel and are recognised with the ability to recruit and retain staff. We will watch this space but there won’t be any [industrial] action before Christmas.”
Harrogate District Hospital has 1,300 people waiting more than a year for an operation.
Jonathan Coulter, chief executive at Harrogate and District NHS Foundation Trust, said the number of patients waiting was a legacy from the covid pandemic.
The trust estimates that it currently has a total waiting list of 25,000 people – an increase of 7,000 before covid.
Mr Coulter said part of the reason for the increase is because the hospital halted some operations during the pandemic.
He told a Harrogate and Knaresborough area constituency meeting of North Yorkshire County Council yesterday:
“We never ever had people waiting over a year for planned care at all in Harrogate.
“Most people were seen within four months. That was the majority.
“We now have 1,300 people waiting over a year for their operation or their treatment. We did go over two years in some cases, but that has now come down.”
Read more:
- Plea for Harrogate hospital visitors to wear masks after people refuse to follow guidance
- Harrogate hospital trust plans home care service to tackle bed blocking
- Harrogate hospital staff selling days off to cope with cost of living crisis
Mr Coulter told the meeting that the hospital expected to have no patient waiting more than a year for an operation by the end of 2023.
He added that the trust board had approved an increase in capacity at the hospital to help deal with the long waiting list.
The £14 million project will see two additional operating theatres, two procedure rooms and a 12-bed ward for patients who require extended stays in care built on the site.
The trust also hopes the project will help to “future proof” the hospital for a growth in population and changes in demographic in the district.
Mr Coulter said:
Hospital ‘under greater pressure than winter’ as staff struggle to free up beds“We will be going through that process next year to get us some more capacity on the site.”
The chief executive of Harrogate hospital has warned it is under greater pressure than in winter as staff struggle to free up beds occupied by covid patients and those waiting for social care.
Jonathan Coulter said the recent rise in covid cases and a lack of available care services meant patients were staying in hospital longer than they should.
He added this was having an impact on A&E waiting times which “remain below the standard we would want”, with over a quarter of patients waiting more than four hours to be seen.
Mr Coulter said in a report:
“We are now in mid-July, and the acute pressures, the bed occupancy, the community services workload are all greater than you would often experience in mid-January.
“During the month of June and into July, we have experienced a significant spike in people in hospital who are covid positive.
“We have currently over 35 people in hospital with covid, and whilst the severity of the illness is reduced due to vaccine uptake, the infection control measures that we have had in place result in flow through the hospital being more difficult.”
Read more:
- Positive covid patients at Harrogate hospital doubles in three weeks
- Harrogate hospital records increase in heat-related illnesses
- More than 130 Harrogate hospital staff absent due to covid in June
Mr Coulter said covid was also having an impact on staffing levels, with around 80 staff currently off work after absences climbed above 130 in June.
He described the pressures on the wider health and care system as “enormous” and said the problem of bed blocking – where patients are medically fit to be discharged from hospital but have no care packages available – needed to be addressed.
He said:
“We continue to have a significant number of patients who are medically fit within hospital, our length of stay has increased, and we have many times more patients in hospital over 14 days and 21 days than we ever had before the pandemic.
“This reflects the pressure in care services out of hospital, and we are discussing across the system how we can reduce this risk.
“We know that if people stay in hospital for a significant time that outcomes deteriorate, and we are currently at risk of worsening care for our population as a result of some of the urgent care pathway pressures being felt across all organisations.”
Mr Coulter added the hospital was continuing to take ambulance patients from outside the Harrogate district and that while this was creating added pressure, it was “absolutely the right response”.
He said:
“Despite the pressures locally, we continue to offer significant support to colleagues in other parts of our system, in particular York Trust.
“During June, in line with previous months, we had numerous ambulances diverted to the Harrogate site, which resulted in on average around 15 additional beds occupied by patients admitted as a result.
“This is absolutely the right response to system support, but we need to recognise the impact upon our colleagues who have to organise and arrange this care.”