Ambulances at the Norfolk and Norwich University Hospital on a busy evening.
PHOTO BY SIMON FINLAY
‘No quick fix’ to ambulance handover delays at N&N
By Adam Gretton
Thursday, March 7, 2013
2:59 PM
Health chiefs admitted there were no quick fixes to slow ambulance turnarounds after it emerged that the Norfolk and Norwich University Hospital could be hit by fines of up to £3.5m a year.
Members of the Norfolk Health Overview and Scrutiny Committee expressed their concern today after Norfolk’s main hospital had been unable to address the problem of ambulances queuing at the front door of the Colney site with patients waiting to be seen by A&E staff.
The extent of the problem was demonstrated on Wednesday night when 17 ambulances were queued up outside the N&N.
Ambulance officials said the problem was contributing to the service’s slow response times in Norfolk, which has led to the trust receiving criticism from MPs and patients in recent months.
Councillors were told that all NHS organisations in central Norfolk were working together to try and resolve the issue of a handover delays.
The Norfolk and Norwich University Hospital is required to meet a target of seeing 85pc of patients within 15 minutes of their arrival by ambulance. However, that figure for the last ten months is 76pc.
Chris Cobb, director of medicine and emergency care at the Norfolk and Norwich University Hospital, said the foundation trust could be hit by financial penalties of up to £3.5m a year, which would pose a “significant impact.”
The meeting heard that full beds in community hospitals and on inpatient wards in acute hospitals was creating a backlog at A&E and delaying new admissions.
Interim ambulance chief executive Andrew Morgan said the trust had sped up the time it takes to get back on the road following patient handover as part of efforts to improve the performance of the NHS trust.
Jonathon Fagge, chief executive officer of the Norwich Clinical Commissioning Group (CCG), which will be responsible for the commissioning of health services in the Norwich area from April 1, said fines for handover delays aimed to be a deterrent. However, there was no “quick fix” to handover issues although he was optimistic that Project Domino, which was launched at the end of last year to improve emergency and urgent care in central Norfolk would start delivering results.
Michael Carttiss, chairman of the health committee, said the problem of handover delays was a “minefield” and “very complex.”
“The ambulance service’s problems are not all the fault of the ambulance service and will not be solved by 15 new ambulances when they have the crews to man them,” he said.
See Friday’s EDP for more.
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26 comments
@andy - I agree with your comment about the GNDP and our councils, and their determination to build tens of thousands more homes in the Norwich area over the next fifteen years. (And yes, if you read the small print they are not just planning for local growth, but also anticipating major immigration from other parts of the UK.) If this ten-year-old hospital is already inadequate for Norfolk's present population, how's it going to cope if the GNDP's housing expansion scheme has 'succeeded' by 2026??
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gilded beams
Monday, March 11, 2013
We know a good deal about the roots of the problem - the hospital was built too small (as many knowledgeable people observed at the time) and there are not enough staff in A&E to give the service there resilience when people are off sick etc. But surely to 'resolve' the situation by FINING the NNUH Trust is simply deranged. Won't this have the effect of draining yet more resources - and putting Norfolk people who depend on the hospital at greater risk than they are already?
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gilded beams
Monday, March 11, 2013
Improving access to the N&N could shave 1.5 minutes of emergency times, but the handover time can only improve with N&N internal changes, i.e. a more responsive A&E needs more staff for greater flexibility.
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ingo wagenknecht
Monday, March 11, 2013
Andrew Morgan comes across all concerned and demanding action!!! This is the man who was chief exec of the Norfolk PCT until September, he is fully aware of the background to the problems with capacity at this hospital. He is also fully aware of the massive debt it is in due to funding it with a PFI contract. He is a major part of the problem as he did not act on the undercapacity situation when he was in a position too. It is interesting when you look at companies who deal in PFI funded projects, the Directors often appear as both directors of funding companies and local pfi developments. It needs an investigative journalist to sit and look at some company information, starting with the directors of Octagon healthcare would be a good start. Perhaps Mr Conrad would like to do that as a follow on to his program today.
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Canary Boy
Friday, March 8, 2013
Perhaps the Health Chiefs should pay the fine - bet they would find a quick fix!!!
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Lisa Johnstone
Friday, March 8, 2013
No quick fix!!!! - Why don't we fire these baffoons running the hospital and recruit some individuals 'Who can' ideally from the commercial sector - Whilst we are there bring back Matrons - clean the hospitals and drop degree nursing you don't need a degree to care for ill people.
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Lisa Johnstone
Friday, March 8, 2013
Omnishambles - I am not suggesting it is all down to the last government - the damage has continued and accelerated under this one. However it was the last government that introduced the target obsessed culture, and PFI hospitals that were meant to solve the problems - but at least in the case of the NNUH were too small, and with financial deals that will be a noose around the tax payers for 20+ years. Going back to the original topic the idea of fines is madness - the way to solve the problem is to bring in a new management team with compotent organistaional skills. The hospital is presently managed by financial bean counters - guess where their priorities are.
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JB
Friday, March 8, 2013
Where is my latest comment - stuck in your Pyongyang-inspired moderation queue I bet
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Mr Cameron Isaliar
Friday, March 8, 2013
Oh woe, there's "no quick fix". And if you thought that is bad, dear Dave C is saying there's no magic money tree to fund tax cuts either. Not even one? Did they have to chop down the entire forest just to pay for scrapping of the 50p tax rate for the benefit of the super-rich. Who are the sort of people I am thinking of - try NHS trust directors whizzing around in Porsches and the like. All part of their jolly reasonable remuneration package you know. A fair reward I say for a fine job done. Must keep in budget even if it means patients laying around dying in ambulances as they queue up for admission. Anyone important, like said directors, can afford to go private after all. Hang on a mo, DC also saying won't borrow more to fund tax cuts like the last lot, but unlike the last lot he has already borrowed in under 3 years almost as much as it took them a whole decade to squander, and I wager some of that has gone to fund abolition of the top rate. But it’s OK, with all this talk of austerity no one has rumbled him! What a clever wheeze, what what.
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Mr Cameron Isaliar
Thursday, March 7, 2013
JB all very well you trying to blame the last government but the fact is the number of patients spending more than thirty minutes in an ambulance outside hospitals has gone up by a third since the last general election under Norman Lamb, Jeremy Hunt, and David Cameron's watch.
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omnishambles
Thursday, March 7, 2013
Perhaps the time has come to re-open the old hospital.
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GoodRockinDaddy
Thursday, March 7, 2013
The hospital was never big enough . That was obvious to everyone at the time . It was financed so that the government didn`t have to put a penny in .The PFI scheme turned out to be a licence to print money for financiers . The result is an expensive inadequate hospital in the middle of nowhere . Tinkering around the edges is a waste of time . Only chance is when they build a replacement in 30 years time or so .
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dragonfly
Thursday, March 7, 2013
I have no idea why my comment keeps being repeated - I only pressed sumit once - perhapsthe EDP could sort thisproblem out - thanks
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JB
Thursday, March 7, 2013
Andy, You are absolutely right that the hospital was never big enough - a problem known and reported on at the time. However, the first move as far as beds are concerned must surely be to sort out the bed blocking problems - another well known and reported issue - community hospital beds are run own whilst the significantly more expensive acute hospital cannot discharge patients who would be fine in the community hospital - as I said before are the inmates running the asylum? Is this what Messrs Blair, Brown, Cameron, Clegg and Milliband see as "joined up government" for they are all to blame. However, the NNUH A&E problem has been known for a long time and its highly paid management team has done lots of talking but made little or no progress - 17 ambulances queuing outside is a scandal and resignations or sackings for those who have failed to solve the problem should be the next step. God save us from the bean counters who mistake talking about problems as progress (and I would guess they get bonuses for good performance as well)!
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JB
Thursday, March 7, 2013
I would love to know how the figure of 76% seen within 15 mins is reached. Why not wanting to be too critical, my own experiences have been much longer. Namely, 2 hours twice and one and a half hours. In a period of five years
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sharky
Thursday, March 7, 2013
Andy, You are absolutely right that the hospital was never big enough - a problem known and reported on at the time. However, the first move as far as beds are concerned must surely be to sort out the bed blocking problems - another well known and reported issue - community hospital beds are run own whilst the significantly more expensive acute hospital cannot discharge patients who would be fine in the community hospital - as I said before are the inmates running the asylum? Is this what Messrs Blair, Brown, Cameron, Clegg and Milliband see as "joined up government" for they are all to blame. However, the NNUH A&E problem has been known for a long time and its highly paid management team has done lots of talking but made little or no progress - 17 ambulances queuing outside is a scandal and resignations or sackings for those who have failed to solve the problem should be the next step. God save us from the bean counters who mistake talking about problems as progress (and I would guess they get bonuses for good performance as well)!
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JB
Thursday, March 7, 2013
Andy, You are absolutely right that the hospital was never big enough - a problem known and reported on at the time. However, the first move as far as beds are concerned must surely be to sort out the bed blocking problems - another well known and reported issue - community hospital beds are run own whilst the significantly more expensive acute hospital cannot discharge patients who would be fine in the community hospital - as I said before are the inmates running the asylum? Is this what Messrs Blair, Brown, Cameron, Clegg and Milliband see as "joined up government" for they are all to blame. However, the NNUH A&E problem has been known for a long time and its highly paid management team has done lots of talking but made little or no progress - 17 ambulances queuing outside is a scandal and resignations or sackings for those who have failed to solve the problem should be the next step. God save us from the bean counters who mistake talking about problems as progress (and I would guess they get bonuses for good performance as well)!
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JB
Thursday, March 7, 2013
I do tend to agree with the majority of the comments here. I suspect that the problem is multifarious possiby not enough funding, poor management of resources, waiting times for crews at A&E, health 'tourism', increased population etc etc. Whatever the causes, fining the trust hardly seems to me to be an especially helpful approach to adopt; if anything it is perverse. It is a rather worrying situation which I hope is resolved soon.
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Jaguar
Thursday, March 7, 2013
No-one has commented on the obvious error in this artcile: where is the obligatory photo of the grinning toad, Norman Lamb, demanding action?
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Police Commissioner ???
Thursday, March 7, 2013
Andy, You are absolutely right that the hospital was never big enough - a problem known and reported on at the time. However, the first move as far as beds are concerned must surely be to sort out the bed blocking problems - another well known and reported issue - community hospital beds are run own whilst the significantly more expensive acute hospital cannot discharge patients who would be fine in the community hospital - as I said before are the inmates running the asylum? Is this what Messrs Blair, Brown, Cameron, Clegg and Milliband see as "joined up government" for they are all to blame. However, the NNUH A&E problem has been known for a long time and its highly paid management team has done lots of talking but made little or no progress - 17 ambulances queuing outside is a scandal and resignations or sackings for those who have failed to solve the problem should be the next step. God save us from the bean counters who mistake talking about problems as progress (and I would guess they get bonuses for good performance as well)!
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JB
Thursday, March 7, 2013
There is a quick fix to this and that is to educate the public to use AE properly.
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loco
Thursday, March 7, 2013
And of course, the 10,000 new houses that are scheduled to built under the GNDP will not have any adverse impact whatsoever!! To say nothing of the other 27,000 new houses scheduled to be built in Norfolk. The reality is that the N&N is simply not big enough which is what many of us said when it was first proposed. We should call ahalt to all future new development until this issue has been resolved. To those who say this is unfair on those looking to buy a house, I agree but what price putting ever more people at risk by not providing adequate medical care???
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andy
Thursday, March 7, 2013
I trust those who are supposedly in charge do not receive bonuses? If those individuals had to pay a fine what are the chances the problems would soon be resolved?
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andy
Thursday, March 7, 2013
Are the inmates running the asylum? What is the good of fining NNUH £3.5M when they are already under-funded? Who gets the money and who does it come from - ourselves presumably. What we need is to get rid of the failing NNUH Chief Executive and her managers who are supposed to be in charge of A&E. Bring in a new team, and if they can't hack it try other ones - these people are very well paid to solve these problems not preside over them! Given that the bean counters who run the NNUH seem to worry about money and targets more than patients these fines will just make things worse - and probably need even more bean counters for their administration!
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JB
Thursday, March 7, 2013
Are the inmates running the asylum? What is the good of fining NNUH £3.5M when they are already under-funded? Who gets the money and who does it come from - ourselves presumably. What we need is to get rid of the failing NNUH Chief Executive and her managers who are supposed to be in charge of A&E. Bring in a new team, and if they can't hack it try other ones - these people are very well paid to solve these problems not preside over them! Given that the bean counters who run the NNUH seem to worry about money and targets more than patients these fines will just make things worse - and probably need even more bean counters for their administration!
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JB
Thursday, March 7, 2013
How predictably perverse. A system of "fines" will do nothing more than further restrict funding to the front-line. It will not address the root cause, i.e. inept management decision-making, and why would it. The pen-pushers will not lose their jobs, instead they will form a defensive huddle, cushioned in spin, and probably recruit a few more like-minded souls to find ways of making the front-line more "efficient" to cope with the reduced funding available post fines. Who are the faceless bureaucrats presiding over the failure? Well if you consider the very top roles are typically filled by failed Consevative politicians, business people "in" with the Tories, and such like, it should give you some clue re the types who will be chosen to fill the next tiers in the hierarchy.
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Mr Cameron Isaliar
Thursday, March 7, 2013