Friday, 26 April 2013

A failure driven by acuity.



The Board of Ashford and St. Peter’s NHS Foundation Trust, met yesterday, 25/4/13, which means a little burst of transparency; here’s an extract from the newly published minutes of the 28/3/13 meeting. I’ve added a few comments of my own;


The Deputy Chief Executive confirmed that the Trust did not expect to meet the four hour waiting time target with an expected performance against the 95% target of 92-92.5%.”


That’s what I worked out from the NHS ‘Weekly Sitrep’s”, here’s the blather and excuses;

This failure had been driven by acuity with an increase in majors patients, the lack of investment and instability within the local health economy to meet winter pressures and the increase in complex discharges with the number of people waiting to be discharged averaging at 40-50 in Quarter one through to quarter three but 80-90, and peaking at 103, in quarter four. The national context was presenting a similar picture with Monitor recently publishing a report which identified that 36% of acute trusts had missed the waiting time target at quarter three, a quarter which ASPH had achieved, and current figures indicating that 27 of the 37 trusts in the South of England would not achieve the quarter four target.”

This next passage reflects the new set up at A and E, effectively a form of triage. That’s the way they used to do things, in the old days, let’s hope things get better;

“The Deputy Chief Executive confirmed to the Board the progress which had been made despite the forecast failure of quarter four. The IST had confirmed in December 2012 that the new model of care in the emergency department had been implemented with actions complete.”

New staff! More on this another day – looks like a rumour I heard, that my favourite consultant has gone, was true.

“Clinical engagement was also far improved from the prior year with strong candidates having been appointed to substantive positions within A&E. In 2013/14 the actions implemented would continue to be embedded to ensure the improvements made were sustainable.”

Not our fault;

“Peter Taylor, Non-Executive Director sought assurance that there was confidence that performance would be back on track in 2013/14. The Deputy Chief Executive assured the Board that the model of care worked and the right team was now in place to deliver this however risks remained predominantly due to elements of the pathway which were out of control of the Trust. The level of complex discharges had reduced to 70 in the current week which was a positive sign for the performance of quarter one.”

The Board NOTED the report.


Here are the figures, it was better that week;

                        Type 1          Type 2

31st March        97.3              97.7

But then afterwards it all went south again;

7th April             93.7              94.4

14th April           83.5              86.2

Remember, these are the percentages of A and E patients seen in 4 hours or less, the target being 95 %.


By the way; “This failure had been driven by acuity” - I think this bureaucratic B/S means that he thinks the failure to see the patients in time was caused because there were too many patients.

I’m sure what he really meant to say is that it was caused by there being too few staff:


10 consultants at A and E, for you and me.

Neil Harris

(a don’t stop till you drop production)

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