The BBC has been doing some interesting research on Accident and Emergency departments in general, which has some relevance to St. peter's A and E, which was the original reason for starting up this Blog.
Way back when, A and E's had a target that they had to keep - 97 % of patients arriving needed to be discharged or admitted to a bed within 4 hours. It was felt this was the best way of measuring an urgent treatment department. Separate figures were kept for patients who waited longer than 4 hours to be dealt with, or longer than 12 hours.
The Conservatives, decided to reduce the target to 95% to be dealt with within 4 hours, to make it easier for the NHS to keep to it's targets.
NHS Trusts which consistently failed to meet the targets would lose money as a penalty, so it wasn't just serious for patients waiting at the hospital.
Last year, as things got worse in the NHS, the government quietly indicated that failure to meet requirements would no longer result in 'fines'.
In fact, over the last twelve months, the targets have been missed even by efficient and well run hospitals, mainly because it's now accepted that most of the NHS is underfunded and unable to manage it's targets.
Now the BBC has discovered that there has been some widespread misuse of 'Drop-in Centre's' to game the statistics.
Lets take, as an example, Ashford and St. Peter's NHS Foundation trust. It runs a traditional Accident and Emergency Department at St. Peter's where patients arrive on foot or in ambulances with problems that range from the trivial to the most serious. Obviously, on arrival they are subject o the collection of statistics leading to the figures that indicate whether the Trust can meet the four hour target.
In fact there is also a 'Drop-in Centre' next to Ashford Hospital. It's not an A and E, ambulances don't call there, it doesn't deal with emergencies.
In fact it's very useful; staffed by nurses you can go there without an appointment and get seen for minor problems. If it turns out to be serious the Nurse can arrange for a transfer to A and E. I went there to have dressings changed and it usually takes about an hour or so. In the past it was attached to a G.P's surgery which was intended by the Blair Labour Government to see people in the evenings and weekends. It's just been closed to save money.
The thing is, the Drop-in centre's statistics go into the figures for Accident and Emergency for the hospital as a whole. Now, no one attending the Drop-in Centre is going there instead of going to A and E - this is non serious problems. The kind of thing that the practice nurse at the Doctors could deal with - but you can be seen without an appointment.
So, in one way the Trust is encouraging people to come in to improve the number of people being seen within 4 hours, because most people attending have quick, simple problems. If you shut the centre, none of the people would be on their way to A and E.
In fact, the BBC has uncovered that not only is this a common practise but some unscrupulous Trusts have been including figures for patients attending Drop-in Centres that have nothing to do with them, in order to massage the A and E to look better.
This 'gaming' of statistics to make them look better is more common in the NHS than you would think - this time there may need to be a recalculation of all last years statistics to find out what the real position was at our A and E's.
The effect of this fixing of the figures makes life harder for patients and easier for over paid NHS managers.
We shouldn't let them off the hook this time.
Neil Harris
(a don't stop till you drop production)
Home: helpmesortoutstpeters.blogspot.com
Contact me: neilwithpromisestokeep@gmail.com
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