Worsening casualty pressure a sign of NHS under strain

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PERFORMANCE of A&E departments is a bell-wether for the NHS as a whole and often an early sign of wider pressures.

Waiting times saw a sudden deterioration in the autumn of 2012 with casualty units in Hull, Barnsley, York and Scarborough among those hit hardest.

Official figures show there has been a long-term increase in numbers of patients seeking urgent or emergency care with demand up by a quarter in York and Scarborough in the five years to 2012-13, 22 per cent in Sheffield and the Mid Yorkshire Hospitals NHS Trust and 19 per cent in Bradford.

A combination of factors have been blamed among them that elderly people suffering from multiple illnesses are often difficult to treat, taking up more staff time.

There have been claims difficulties getting GP appointments have led to more patients heading to A&E amid evidence perhaps as many as 40 per cent could be dealt with elsewhere. Meanwhile, difficulties recruiting doctors have left gaps on rotas.

A landmark review led by NHS medical director Prof Sir Bruce Keogh will trigger major changes with numbers of major A&E units providing the full range of services potentially reduced to around half a dozen in Yorkshire, while better care is developed outside hospital provided in urgent care centres and or even by paramedics.

John Saxby, chief executive at Hull and East Yorkshire Hospitals NHS Trust, said a major expansion of the Hull Royal Infirmary’s emergency department was underway and further changes to referrals of patients were planned.

He said: “Whilst there is no single reason for the high volume of attendees, we are dealing with a larger number of sicker patients which undoubtedly adds extra pressure on the services we provide.”

In a further sign of strains, figures obtained by The Yorkshire Post show nearly 2,800 patients arriving by ambulance waited between 30 and 60 minutes in 2013-14 at York and Scarborough hospitals before A&E staff were able to deal with them, 900 waited more than an hour and 51 in York waited more than two hours. Overall, around one in 10 patients arriving by ambulance waited more than half an hour. The problem cost the hospitals £300,000 in fines in the three months to June.

Officials say the opening of a new £1m assessment area for often very sick patients in York at the end of June has eased problems, and there are plans for a similar development in Scarborough early next year.