More operations cancelled at Colchester General Hospital during major incident

Colchester General Hospital

Colchester General Hospital

A further 12 operations were cancelled today at Colchester General Hospital as a major internal incident continues at the site.

The hospital said it was “not yet in a position” to end the incident, called on Thursday morning as it neared capacity.

It brings the total of operations cancelled so far to 30, in a bid to free up staff and beds to deal with a high number of patients, and the hospital anticipates cancelling more non-emergency, non-cancer operations tomorrow.

The major incident was declared in the wake of an unannounced visit by Care Quality Commission (CQC) inspectors following a “requires improvement” finding by the watchdog in July.

A spokesman for Colchester Hospital University Foundation NHS Trust (CHUFT), which runs the hospital, said: “We have seen some relieving of the pressure on the hospital over the weekend and into today [Monday] but we are not yet in a position to stand down the internal major incident.

“The majority of our elective operations are carried out on a day case basis – they do not require patients to overnight at the hospital – and these are continuing as normal.

“We are postponing these operations reluctantly and apologise to all those patients who are affected. They will be given a new date within 28 days.

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“In terms of A&E today we have seen quite low numbers of admissions. In terms of attenders, there were 115 by 4pm today whereas we would normally expect 160-170.

“This morning we reopened our Emergency Assessment Unit to direct referrals from GPs. They had previously been coming into the hospital via A&E.

“We are reviewing the situation daily and the decision to stand down the internal major incident is one we will take jointly with our partners, principally North East Essex Clinical Commissioning Group (NEE CCG), who have been tremendously supportive.”

Douglas Carswell, MP for Clacton which is also covered by the hospital, said: “I am so alarmed I am writing to Jeremy Hunt [health secretary] asking if he could urgently explain what he is going to do. There is an alphabet soup of agencies and we need to know who will take charge.

“There seems to be a serious management problem at that hospital and confidence has been badly shaken. I am not sure the local management team can sort this out.

“We must stop regarding the patients as the problem. Of course there are a lot of them, but all of them have spent their working lives paying into the system and in any other walk of life customers are regarded as an opportunity not a burden.

“It is ridiculous telling patients not to come unless it is urgent. Supermarkets don’t tell shoppers not to come unless they are starving.

“It is a management failure to put the patient at the centre of treatment. It is outrageous to suggest patients are being a nuisance.

“If there are bottlenecks it is the bottle that has got to be changed.

“I don’t want to ‘heads should roll’. But those in a position of responsibility need to spell out very clearly what they are going to do.”

At the weekend Colchester MP Sir Bob Russell also called for high level talks with the health minister to address the situation.

Safeguarding issues were also raised by the CQC during its visit.

Interim trust chief executive Dr Lucy Moore said: “The CQC raised a small number of safeguarding concerns when its team gave immediate feedback at the end of the inspection on Wednesday.

“The trust takes safeguarding extremely seriously and is now investigating to find out whether our policies had been followed appropriately.”

This is the latest in a series of problems faced by CHUFT.

It was investigated by Sir Bruce Keogh after its mortality rates were flagged up as being particularly high, and then placed in special measures by regulator Monitor after concerns were raised that cancer waiting times had been fixed in order to meet targets amid a culture of bullying.

The trust has failed to appoint substantive replacements to its board and is also facing a shortage of nurses, though the latter issue is not exclusive to Colchester.

What is being done?

In the short-term several steps have been taken to reduce the pressure on Colchester General Hospital’s A&E department.

The hospital itself has cancelled non-emergency operations and drafted in extra staff to help treat patients, while a specialist team is working to discharge as many patients as possible provided it is medically safe to do so.

Essex County Council is also helping with social care staff provising extra support to speed up discharges.

Anne Brown, councillor for adult social care at County Hall, said: “Social care staff have been working hard to identify anyone who can be discharged from Colchester General Hospital.

“We are providing reablement support at home whilst permanent arrangements are made and we are also providing specialist equipment so that patients can be looked after in care homes.”

The North East Essex Clinical Commissioning Group (NEE CCG) is advising patients to seek the most appropriate place for treatment, by using minor injury units, GPs, pharmacists or the 111 NHS number where possible,

It is also funding a new X-ray facility at the Colchester Walk-in Centre, run by Care UK with staff from the hospital, which is open seven days a week.

This means patients can be given advice and strapping without the need for an A&E visit if the X-ray is normal, and speed up treatment at the department if a fracture is found.

Longer term all health bodies in the area are working together to implement an urgent care strategy, being led by the NEE CCG.

It aims to reduce A&E attendances by 10% by the end of 2015, with a continuous reduction of 2% over the following three years, by making more care such as GPs accessible at weekends and evenings.

A NEE CCG spokesman said: “There has been a continued rise in demand for urgent and emergency care. Managing this demand in the future may become unsustainable within the current arrangement of services.

“We are therefore working with our providers and communities to model our urgent care system in such a way that it delivers an outstanding level of care in all areas.

“We believe that for this to be successful, the whole care ‘system’ locally must be much more joined up so that we can treat more people in the community without them needing to go to hospital.

“This is not only better for the patient, but it also makes the local healthcare system more efficient so those people who really need hospital care get it as quickly and effectively as possible.”

What health authorities say?

Health watchdogs have made a number of statements following the latest situation at Colchester General Hospital.

Professor Mike Richards, Chief Inspector of Hospitals at the Care Quality Commission (CQC) said: “CQC carried out an unannounced inspection at Colchester Hospital this week in response to concerns. The inspection looked at the A&E department and the Emergency Assessment Unit.

“Following the inspection, we gave feedback to the trust about our safeguarding concerns so that it could take appropriate action to ensure the safety and wellbeing of its patients.

“We will return to carry out further inspections at the trust and we are working urgently with Monitor to resolve these issues.

“A full report of CQC’s findings will be published on our website in due course.”

A Department of Health spokesman said: “We established the role of the independent Chief Inspector of Hospitals, and set up the toughest inspection regime in the world, precisely to root out poor care wherever it takes place – meaning that any problems can be confronted and sorted out quickly, unlike at Mid Staffs where sadly they were allowed to persist for years.”

Regulator Monitor, which oversees foundation trusts, put Colchester Hospital University Foundation NHS Trust in special measures in November last year in the wake of the cancer waiting time scandal. Since then the trust has been partnered with the Royal Marsdesn Hospital trust to help it make improvements.

A Monitor spokesman said: “Monitor is working closely with both the CQC and the trust to ensure improvements are made so all patients can receive quality care.”