The removal of services such as cataract operations from Margate’s QEQM Hospital and the number of patients leaving A&E without being seen due to extensive waiting times will result in a “critical incident,” says district and county councillor Karen Constantine.
Cllr Constantine sits on the Kent County Council Health Overview and Scrutiny committee and says a number of people have contacted her over their concerns.
She said: “I’m aware that the situation at QEQM is getting worse. There are a plethora of services that are now under threat, very many patients are reporting inadequate arrangements and chaotic treatment, with cancelled appointments, lack of regular consultant consultations and an increasing drive to send patients to other areas for treatment that has until recently been delivered locally, at QEQM.
“This includes orthopaedics,some Accident and Emergency treatment and operations, causing concerns. In recent days it has also been announced cataracts operations will be stopped.“
The East Kent Hospitals University Foundation Trust (EKHUFT), which is responsible for health centres including QEQM, has a long-term strategy to locate more of its specialist services together so that patients are seen faster by teams of experts working together. The strategy includes investing in larger emergency departments and having a centre of excellence for planned care like hip and knee operations, to avoid operations being cancelled because beds are taken up by emergency patients.
An EKHUFT spokesman said: “East Kent Hospitals would like to move cataract surgery from Queen Elizabeth The Queen Mother Hospital (QEQM) to a specialist centre in the Buckland Hospital, Dover, to improve the quality of service for these patients.
“The operating theatre nurses at QEQM are becoming deskilled in cataract procedures due to the limited number of cataract operations performed there (approximately 380 patients a year).
“Providing the service at the Dover centre would ensure patients are looked after by a nursing team that has the critical skills needed. It would also ensure patients are treated faster, as the service would not have to compete with other demands on the operating theatre resources of a large acute hospital.
“The Trust is also considering moving non-complex cataract procedures from William Harvey Hospital in Ashford to the Buckland Hospital centre for patients who live closer to Dover. It is anticipated the moves will begin in early December 2017.”
The NHS in East Kent is planning to take proposals to reconfigure services out to public consultation in Spring 2018.
The proposals are part of the Health and Social Care Sustainability and Transformation Plan (STP), created by Kent and Medway health trusts, the NHS, Kent County Council and Medway Council, sets out proposals to reduce ‘the estate’ – meaning the sale of assets and property – and “invest in housing and community facilities.”
The proposal is for one emergency hospital to provide specialist services, A&E, a trauma centre, planned care and maternity with a second hospital offering A&E, maternity and planned care.
A third site would provide planned care, supported by rehabilitation services and an urgent care centre led by GPs.
There would be further development of a Kent cancer centre.
The strategy is aimed at saving health services in Kent and Medway some £292million.
Pressure on A&E
A scaling back of services at the Kent and Canterbury Hospital this year has also applied pressure to Margate’s A&E. This took place after it was revealed that trainee doctors were to be moved to Margate’s QEQM Hospital and the William Harvey Hospital in Ashford due to a shortage of consultants to oversee them at Kent and Canterbury.
Hospital bosses said A&E pressures were due to a lack of permanent staff and dealing with 13 extra urgent patients every day being brought from Canterbury following the changes at K&C Hospital.
Cllr Constantine said hospital staff had expressed concern over patients leaving without being treated.
She said: “I am anxious about what I see as a growing pattern of ‘near misses’. I have been contacted by people who are expressing severe concern that It’s only a ‘matter of time’ when a ‘near miss’ becomes a critical incident.
“These very recent near misses involved people reporting to A and E who have to wait so long that they don’t wait for treatment. Members of staff report that this causes great concern as these members of the public have been deemed as in need of further examination and possible treatment.
“Most people do not present at A and E for the ‘fun’. This in turn creates a stress for A and E staff as committed health professionals they do not like to see people leave without treatment. They fear this will lead to a ‘critical incident’ possibly a fatality.
“It was reported to me that a toddler was bought into A and E with a very high temperature, because of the dire waiting times, even this vulnerable infant who required prompt treatment was required to wait three hours for treatment.
“This waiting time is unacceptable.“
Cllr Constantine says yesterday’s (November 22) budget announcement that revealed a lack of extra funding for health and social care and mental health services would only exacerbate dire underfunding and understaffing locally.
An EKHUFT spokesman said: “The staff who work in our emergency department at the QEQM work very hard to ensure that patients are seen as quickly as possible. A&E nurses give immediate assessment to patients as they arrive to make sure those experiencing urgent or life-threatening conditions are prioritised and receive appropriate care. We monitor the safety of patients attending the emergency departments extremely closely.
“Overall, waiting times are improving and the QEQM and elsewhere. By mid-November 69.6% of patients were treated, admitted to a hospital bed or discharged within four hours in the ‘majors’ area of east Kent’s emergency departments, and 80% of patients across both the emergency departments – the QEQM and the William Harvey, and minor injuries units.
“We are at the start of our 12-month improvement plan, but the early signs of progress are very encouraging.
“We have also expanded and improved the facilities in the emergency departments to improve the environment for patients, and three consultants and three specialty doctors have started in our emergency departments in the last two months. A further five are expected to start this month.”
The government target for being treated within the four hours is 90% and will rise to 95% in March 2018.
In September, following a Birchington mum’s 16 hour wait in A&E, hospital bosses said new doctors were being recruited and staff were putting in place several measures to ease the congestion in the A&E.
The Trust was due to have completed recruitment of 10 new emergency doctors by this moth. It is hoped this will deal with A&E waiting times for non-urgent patients, which have been high.