Pioneering deal with NHS Direct will improve cover for patients

Thousands of patients on the North Yorkshire and East Coast will benefit from improved out-of-hours cover – including a pioneering partnership with NHS Direct, the Yorkshire Post can reveal.

Scarborough Health Trust chief executive Richard Sunley believes what the beleaguered organisation has been lacking is a vision for the future of Scarborough, Bridlington and other community sites

The first stage will be more joined-up thinking about providing out-of-hours medical cover presently provided through Scarborough Hospital, the out-of-hours clinician and minor injuries unit at Bridlington, on-call GPs, and NHS Direct.

Nationally, NHS Direct has been criticised for often following a rigid tree of options, which nearly always ends in “go to casualty” for cases which the calls centre advisers do not feel qualified to answer.

But Mr Sunley said many of the patients turning up at Scarborough’s casualty department do not need to be there. In addition, the volume of calls to NHS Direct means they may be outsourced to other areas during peak periods, losing the local touch.

As part of the trust’s Fit for the Future programme – to plan how services should measure up in the future – treatment outside normal surgery times is high on the agenda.

One of the reasons – but not the driving force behind the changes – is the new urgent treatment centre operating in Scarborough, designed to cater for people who slip through the cracks of the normal appointment system.

Central to the vision would be a single point of access for the multiple services. But such a gateway might be provided without needing an actual building.

Mr Sunley believes one option would be a more energetic use of the local NHS Direct: “It could be nurses sent out to people’s homes by NHS Direct,” he said.

He had not heard of a trust employing a similar referral system. “I don’t think it has been done quite so explicitly with NHS Direct anyway.”

Mr Sunley, who has 26 years experience with the NHS since starting as a clerical officer at Watford General Hospital, is the latest in a long line of chief executives at the Scarborough Trust.

He insists he is here to stay and as well as drawing a line under the threat of mass job losses at the trust he says the finances are also back on track.

Some 12m of the trust’s debt has been “parked”, meaning the trust is under no pressure to repay it and it has no impact on the current budgets.

The trust had agreed to balance the remaining 8m deficit in its books by generating a 2m surplus each year for four years.

He said: “We did it last year. We are going to do it this year and in two more years that will clear that 8m debt.”

It has been claimed over recent months by critics of the trust that staff morale is at rock bottom. But Mr Sunley said the problem was that previous management had not been engaging with the employees.

Senior officials were committed to consulting staff every step of the way on what sort of working practices the trust should be seeking to adopt.

He said staff attendance during the big freezes over the winter spoke for itself. “No one rang in to say their car was snowed in and they couldn’t get to work,” he added.

“When it came to it, their morale, fortitude, and sticking together was second to none.” Staff no longer had to worry about job security either.

The changes the trust would be making were designed to improve front line services, not reduce them. But that was a message that in the past the trust had failed to communicate to its critics, he said.