Harrogate and District NHS Foundation Trust Archives - Page 8 of 18

Harrogate hospital reports improved A&E waiting times

People attending A&E at Harrogate District Hospital are experiencing much shorter waiting times than earlier in the year when some patients were forced to stay at the hospital for 12 hours or more.

The department has been under-pressure throughout the winter due to a higher average number of admissions as well as a fresh wave of covid and flu inpatients that has saw the hospital almost completely full every day.

Harrogate has also been a high number of patients aged over 70 attending A&E compared to nationally.

While attendance figures have returned to near pre-covid levels, many patients have experienced longer-than-usual stays due to the high bed occupancy.

It meant some A&E patients had to stay overnight, which has put further strain on staff who have had to conduct medicine rounds, serve meals, wash patients and conduct ward rounds.

Industrial action by paramedics, nurses and junior doctors has also put pressure on the hospital.

To improve the situation in A&E, the hospital introduced a new streaming model for minor injuries so staff can focus on patients with more serious conditions.

Speaking at a public board meeting of Harrogate and District NHS Foundation Trust last week, chief executive Russell Nightingale said the changes have worked.

Mr Nightingale said the number of people waiting for 12 hours was down to the single figures in March.

He said:

“It’s come down hugely and we’re aiming for zero by August. It’s been driven by improvements in the streaming model. That’s been the primary driver.

“We’re working through some of those sticky admittance issues plus the industrial action.”

As the hospital moves out of its most challenging winter period, next week’s junior doctors strike means there is likely to be some disruption for patients.

The strike is set to take place from 7am on Tuesday, April 11, until 7am on Saturday, April 15.

Jonathan Coulter, chief executive of HDFT, told the meeting the hospital has a “robust plan” in place to deal with any disruption should the strike goes ahead as planned.

He said:

“The strike is obviously concerning but I’m confident we’ll have safe services. There’s a cost of people covering the work and planning it and the cost to the patients who have work delayed. Services will be safe and let’s hope theres a solution relatively quickly.”

Harrogate hospital £9m spend on agency staff ‘necessary’, says trust

Hospital bosses in Harrogate have said a £9 million spend on agency staff this year was “necessary”.

Earlier this week, the Stray Ferret reported that the hospital had spent £4.1 million more than its target spend for agencies this year.

Harrogate and District NHS Foundation Trust set a target to spend no more than £473,000 each month on agencies — the equivalent of a maximum of £5.7 million over the year.

The figure covers staffing in areas such as nursing, dental and clinical support staff.

In response to the spend, a spokesperson for the trust said:

“When we experience workforce challenges in our clinical and non-clinical services we will use our bank of nursing staff or the services of relevant recruitment agencies to support staff gaps where necessary. This is an issue faced by all NHS foundation trusts across the country.

“The workforce challenges can be for a variety of reasons, such as when we have vacancies due to colleagues leaving the Trust or being promoted, or staff illness.

“It is important that we maintain a safe level of staff to care for our patients, and this can fluctuate due to circumstance – for instance, over the winter months we generally see a rise in patients with respiratory infections, such as the flu or covid-19, and an increase in the number of patients who cannot be discharged. This will lead to the trust opening more beds to meet demand, which in turn requires additional medical and nursing staff to care for those patients. In such instances, we may need to call on agencies, which can be expensive, but enables our services to continue.

“Whilst the current spend on agency staff across our services is higher than we expected, this has been necessary to ensure we can continue to provide the safest and best possible levels of health care service for our community.”

It comes as Alex Sobel, Labour MP for Leeds North West and the party’s shadow environment minister, described Harrogate hospital’s reliance on agencies as “a disgrace”.

He told the House of Commons in February that a constituent called Marjorie Dunn spent just over seven weeks at the hospital last year.

Mr Sobel said:

“In that time she saw NHS nurses leave the service and she was treated predominantly by agency staff — mistreated, I have to say, by agency staff. It is a disgrace.

“When she was eventually moved to a recovery hub run by Leeds City Council she got excellent treatment there.

“She had broken her pelvis and been told she would never walk again, but it was the council physiotherapist who got her up and walking again. Is it not right that we should be supporting local authorities such as Labour-run Leeds to get such facilities as well as the NHS?”

Harrogate hospital trust spends £9m on agency staff

Harrogate and District NHS Foundation Trust has spent £9 million on agency staff costs this year.

The figure covers staffing in areas such as nursing, dental and clinical support staff.

The trust set a target to spend no more than £473,000 each month on agencies — the equivalent of a maximum of £5.7 million over the year.

However, according to board papers, the trust has spent £9.8 million on agency staff – £4.1 million more than its target spend for the year.

In January alone, the hospital spent more than £1 million on agency staff.

HDFT agency staff spending per month. Table: HDFT.

It comes as Alex Sobel, Labour MP for Leeds North West and the party’s shadow environment minister, described Harrogate hospital’s reliance on agencies as “a disgrace”.

He told the House of Commons last month that a constituent called Marjorie Dunn spent just over seven weeks at the hospital last year.

Mr Sobel said:

“In that time she saw NHS nurses leave the service and she was treated predominantly by agency staff — mistreated, I have to say, by agency staff. It is a disgrace.

“When she was eventually moved to a recovery hub run by Leeds City Council she got excellent treatment there.

“She had broken her pelvis and been told she would never walk again, but it was the council physiotherapist who got her up and walking again. Is it not right that we should be supporting local authorities such as Labour-run Leeds to get such facilities as well as the NHS?”

The Stray Ferret has approached Harrogate and District NHS Foundation Trust for comment.

A spokesperson said previously:

“We pride ourselves on providing the best possible standards of care for our patients, wherever that care may be being delivered. On the rare occasions when this has fallen below our expectations or those of our patients, we have procedures in place to identify this and ensure we continuously improve.

“Workforce challenges in the NHS are well documented. As a trust, we monitor recruitment, retention, turnover and staff wellbeing closely and have a bank of the trust’s own nursing staff, who are available to support where we have short- term absence. These staff are familiar with Harrogate and District NHS Foundation Trust and our standards of care.

“On occasion, we do need to use the services of agencies to support nursing gaps, however we expect all staff working at Harrogate and District NHS Foundation Trust to provide the same standards of care for our patients, and we will address this if it is found not to be the case.”

Inspectors says Harrogate hospital maternity services ‘requires improvement’

Health inspectors have rated Harrogate District Hospital’s maternity services as ‘requires improvement’.

The Care Quality Commission, which inspects hospitals and health services, published its verdict in a report on Friday after an inspection in November 2022.

The CQC visited the hospital as part of a national inspection of maternity services.

Harrogate District Hospital was previously rated ‘good’ in a 2016 inspection that looked at maternity services and gynaecology. This latest report was the first time maternity services were rated as standalone services.

The four possible outcomes are ‘outstanding’. ‘good’, ‘requires improvement’ and ‘inadequate’.

Jonathan Coulter, chief executive of Harrogate and District NHS Foundation Trust, said it was “difficult to understand” the change in the rating.

The CQC report said “compliance with appropriate safeguarding, life support training and medicines did not meet targets” although it acknowledged “there was a plan in place to recover this position”.

It added that the number of medical staff on hand “were not always sufficient” and there was no clear system in place to “to identify prioritise risks to women in the maternity assessment area”.

Regular checks on life saving equipment “were not always completed”, the report said.

Inspectors said staff at the service “did not always receive and keep up to date” with mandatory training.

However, the CQC did find the service had enough midwifery staff to care for women and that staff worked well together.

It added:

“Staff had training in key skills, and worked well together for the benefit of women, understood how to protect women from abuse, and managed safety well. The service controlled infection risk well.

“Staff assessed risks to women in most areas, acted on them and kept good care records. They managed medicines well. The service managed safety incidents well and learned lessons from them.”

‘Not a fair reflection’

In response to the report, Mr Coulter said he did not feel that the findings in the report were a reflection of the service at the hospital.

He said:

“With such positive findings in the CQC report it is difficult to understand the resultant rating change and we do not feel it is a fair reflection of the maternity service we provide. The report describes a maternity unit which is fully staffed, with a positive culture, with staff that are competent, listen to women and are always seeking to improve.

“We are proud of our team for the dedication, professionalism and caring attitude that they show each day whilst supporting those in our care. We are disappointed the rating applied to the service overall and for the safe domain does not appear to reflect the findings in the report.

“Whatever the rating in this report, our response will be to focus on learning and improvement, as it is for any external or internal service review.

“As part of this focus on continually improving our services, we prioritise listening and learning to ensure we can provide the high quality care that our patients deserve. Listening to people who use our maternity services is so important, as we completely understand that peoples’ experience can differ.

“This is why, in addition to our own improvement work, we work in partnership with our Maternity Voices Partnership who provide another valuable way for us to hear the needs of those using our services.”

Call for parents to share maternity experiences in Harrogate district

A group of volunteers is calling for parents to share their experiences of maternity services across the Harrogate district.

Harrogate Maternity Voices Partnership (MVP) is an independent group of volunteers aiming to use feedback from parents to ensure maternity services are the best they can be.

From community midwifery to the hospital’s delivery suite and postnatal care at home, the MVP wants to hear from anyone who has experienced the maternity services provided through Harrogate and District NHS Foundation Trust.

The group’s chair, Jen Baldry, took up the role in early 2022. She said:

“I’ve had three children in Harrogate and I think I’ve had really positive experiences throughout my maternity journeys. However, I always think there’s room for improvement.

“I have a passion for developing local maternity services, in particular focusing on personalised care and informed choice.

“I had a baby during covid so that massively impacted me wanting to do this role and give my experience of that, compared to having two before covid.”

The MVP holds regular coffee mornings around which any parents are welcome to drop in to. They offer space for children to play while the parents can chat to each other, MVP volunteers and maternity professionals about their experiences.

There are also regular, free information sessions, such as one next Friday evening on the biomechanics of birth, led by a hypnobirthing teacher and a student midwife. It will cover how different positions and movements can be used during labour and childbirth.

Feedback over the last year has seen the MVP work with maternity professionals to look at the language they use, the birthing environment at the hospital, and delivering personalised care to suit each person going through pregnancy and birth.

As well as giving feedback, people who have experience of maternity care in Harrogate are always welcomed as volunteers with the MVP. Jen said:

“We have over 40 active volunteers. I ask everyone for one to two hours a month, and that could be for reviewing leaflets or coming to a coffee morning, or even going in to the unit for a ’15 steps’ review, when we look at what the experience is like for someone arriving there.

“Anybody who has had experience with maternity services or worked in a field related to maternity can join us.”

Pilot project

While the MVP will operate long term with all parents, at the moment it is working on a pilot project with the maternity department in Harrogate.

Across the NHS, midwives will soon be required to undertake more training each year. Harrogate’s involvement in the pilot project will see it help to produce training based on feedback from people using its services.

The MVP is helping to find parents to take part and is particularly seeking those who have experienced pregnancies with twins and multiples, surrogacy, their child being cared for on the special care baby unit, or giving birth outside NHS guidance.

It also wants to hear from anyone from black, Asian and minority ethnic backgrounds who has been cared by for through Harrogate’s maternity services.

Two focus group events are being held at the end of March – one online and one in person in Harrogate – to gather feedback from those parents.

Jen said:

“The biggest challenge for the MVP is hearing the voices of people who don’t necessarily speak up.

“People tend to get in touch if they’ve had an amazing experience or a really bad experience. We don’t often hear from that middle ground, where it was fine, but there are some areas that could be improved.

“All those tweaks, we’re here to help with. Was there anything that would have made it even better?

“We also want to ensure we represent everybody in the community, from all different types of background – anybody who has had an experience of maternity services.”

For details of upcoming events, visit the MVP Facebook page.

To contact Harrogate MVP, or give feedback on your experiences of maternity services, visit its website.

Harrogate hospital braced for disruption ahead of junior doctors strike

Harrogate District Hospital has pledged to minimise disruption as junior doctors prepare to stage a 72-hour walkout.

The British Medical Association announced last Friday junior doctors will go on strike from March 13 to 15 in a dispute over pay.

It’s the latest strike action set to hit the hospital after nurses walked out last month. Ambulance workers, teachers, rail workers and postal staff have also gone on strike in the Harrogate district in recent months.

Of the 37,000 votes cast in the BMA industrial ballot on February 20, 98% voted in favour of industrial action.

A spokesperson for the organisation said they had been left with “no option” but to strike after pay negotiations with the health secretary broke down.

A total of 145 junior doctors work at Harrogate and District NHS Foundation Trust. However, it is unclear how many will walk out.

The trust said it was working on plans to minimise disruption caused by the industrial action.

It urged people to continue to come forward for emergency care. But, the trust warned some outpatient appointments may be affected.

A spokesperson for HDFT said:

“We are working hard to ensure there is minimal disruption to patient care and that emergency services continue to operate as normal.

“We are currently developing our plans for the propose action and its impact on our services, patients or staff.

“Outpatients appointments and planned activity may be affected. Patients should continue to attend appointments as planned unless contacted to reschedule. We will be re-arranging any postponed appointments as a priority. We appreciate this situation is frustrating for patients affected and apologise for any inconvenience caused.

“Nobody should put off seeking urgent or emergency care during the strikes, and key services will continue to operate.”

It comes after industrial action by the Royal College of Nursing due to take place this week was suspended after talks reopened with Health Secretary Steve Barclay.

Nurses at Harrogate hospital had planned strike action from today for 72 hours.

Harrogate ambulance striker: ‘Nobody wants to wait three hours to offload patients’

Ambulance workers and nurses formed picket lines within metres of each other in Harrogate today as part of the biggest-ever day of NHS strikes in England.

Members of the Royal College of Nursing began two days of industrial action outside Harrogate District Hospital on Lancaster Park Road.

A two-minute walk away, members of the GMB union were huddled around a fire at Harrogate Ambulance Station for a one-day strike due to take place from 6am to midday and from 6pm to midnight.

Unison ambulance workers are due to strike on Friday.

Nurses strike Harrogate District Hospital

The hospital picket line today

Laura Faulkener, an ambulance practitioner and GMB rep, told the Stray Ferret patients were more likely to get an ambulance today than on non-strike days because of the measures put in place to respond to the most serious incidents.

Asked why the GMB was striking, Ms Faulkner said:

“There’s been a lot of focus on pay but it’s about conditions, above all.

“None of us want to wait seven hours in a corridor with patients while they wait to be seen.”

She said the situation was particularly bad at York Hospital but paramedics could still be left looking after patients in the back of ambulances for three or hour hours at Harrogate District Hospital while they waited to be treated.

Harrogate and District NHS Foundation Trust said in a statement key services continued to operate during the strike and nobody should be put off seeking urgent or emergency care. It added:

“Patients should continue to attend appointments as planned unless contacted to reschedule.”

RCN staff will be taking part in industrial action today (6 February) and tomorrow (7 February). This will impact our services at HDFT. Unless it’s a life-threatening injury/severe illness contact NHS111 https://t.co/h6tkZbXSie #nhsstrikes https://t.co/sUdV7rONPD

— Harrogate NHS FT (@HarrogateNHSFT) February 6, 2023

Harrogate hospital told to reduce 18 month waiting list to zero patients

NHS bosses have set a target for no patient to be waiting 18 months for surgery at Harrogate District Hospital.

Officials at NHS England have told Harrogate and District NHS Foundation Trust, which runs the hospital, that its waiting lists of more than 78 weeks should be brought down by the end of March.

Currently, the trust has 120 patients waiting more than a year and a half to have an operation.

The figure has gradually fallen since April 2022, when 205 people were waiting 18 months or more for surgery.

The number of patients waiting for an operation at Harrogate District Hospital since April 2022. Data: HDFT.

However, the number of patients waiting 52 weeks or more still stands at 1,299 people, an increase on the figure of 1,187 last April.

A spokesperson for Harrogate and District NHS Foundation Trust said:

“During the Covid-19 pandemic there was a risk of the NHS being overwhelmed with the number of patients seriously unwell with the virus. Protecting the NHS became a top priority and to ensure there was hospital capacity to cope with the pandemic, and to protect patients and staff, non-urgent routine hospital treatment was postponed.

“Since we emerged from the pandemic, a key focus for the NHS has been to reduce waiting lists, with a particular focus on those waiting longest for planned care, and to eliminate waits of over 104 weeks by March 2022 and 78 weeks by April 2023.

“Elective (planned) care is planned treatment at our hospital involving specialist clinical care or surgery, following a referral by a GP or health professional. It can refer to elective admission, outpatient appointments and diagnostic services, and relate to many conditions to improve the quality of life of a patient, to help them psychologically, or extend their life – for example cataract surgery, hip replacement, physiotherapy, or reconstructive surgery.

“Our teams have been doing extraordinary work to reduce waiting times and to see patients as soon as possible despite the ongoing difficulties that Covid-19 has caused. They have worked hard to add additional clinics, scans and operations; as well as adapting pathways and using technology to improve our offer to patients.”

Last year, the trust’s board 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.

Nurses and ambulance workers set to strike in Harrogate on same day

Nurses and ambulance workers in the Harrogate district are set to strike on the same day in just over two weeks’ time.

Picket lines could be organised within yards of each other on Lancaster Park Road in Harrogate, where the hospital and the ambulance station are both located.

Unless strikes are averted, the Royal College of Nursing plans to carry out two days of industrial action on February 6 and 7.

Unite has scheduled another ambulance strike in Harrogate on February 6.

Ambulance workers striking in Harrogate this year.

There is also the prospect of schools being affected on February 1, when members of the National Education Union plan to strike before staging further walk-outs in February and March. A union official has predicted some schools will have to close.

Sandy Lay, a nurse at Harrogate District Hospital and a Liberal Democrat councillor representing Otley and Yeadon on Leeds City Council, told a full council meeting on Wednesday the government rather than striking nurses were harming patients.

But he added arrangement for patient care were often better on strike days than non-strike days because minimum service levels were in place,

He said:

“We want minimum service levels and minimum staff levels, but it has to be every day, not just on strike days.”

Hospital: ‘regrettable some services have been affected’

Asked what impact this week’s strikes had had on the hospital, and whether it would amend its plans for future strikes, a spokesman for Harrogate and District NHS Foundation Trust said:

“Comprehensive plans are in place to maintain the safety of patients requiring our services during the Royal College of Nursing’s industrial action.

“We are committed to providing the best possible levels of healthcare in any eventuality, and as ever, during the industrial action our focus has been on maintaining the safety of our patients.

“Whilst it is regrettable that some of our services have been affected by industrial action, we have ensured that essential services have remained available. Whilst we have been operating at reduced staffing levels in a number of areas such as inpatient wards, we worked with the RCN to ensure that we had sufficient nursing staff working to maintain patient safety.

“During the industrial action we have rescheduled appointments where it has been necessary. We have worked with the RCN to ensure that our services have remained safe.

“While pay is a matter for government and the trade unions, we greatly value our staff and respect those who have chosen to take part in industrial action. We want to see a resolution as soon as possible to ensure we can continue to focus on delivering high quality patient care to all those who need it.”

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.

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.”

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‘Not a fair reflection’

Pilot project

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Hospital: ‘regrettable some services have been affected’

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‘Denied liability’