Local hospitals fail to meet A&E waiting time targets since closure of A&E in Welwyn Garden City in 2014

Image: Tom Boon

[Oliver Price | News Manager]

Since the conversion of the Accident & Emergency unit at the Queen Elizabeth II Hospital to an Urgent Care Centre, which only treats non-life threatening injuries, East and North Hertfordshire NHS Trust has been unable to meet the government mandated target of seeing, treating, admitting or discharging 95 per cent of all patients at A&E departments and Urgent Care Centres within four hours.

East and North Herts NHS Trust runs four hospitals, two of which have emergency departments: Lister Hospital in Stevenage and the recently rebuilt Queen Elizabeth II Hospital in Welwyn Garden City.

The A&E at QEII was closed down and replaced with an Urgent Care Centre in late 2014, leaving the Lister as the only full A&E service in all of East and North Herts. Since this has happened, the joint score of seeing, treating, admitting or discharging patients within four hours at the Lister and QEII has gone from meeting the 95 per cent target to the Lister almost consistently never meeting its target and QEII meeting its target in quarter one of 2015-16.

As of quarter three 2015-16, the Lister’s A&E department took more than four hours to see nearly 30 per cent of patients, 25 per cent higher than the target.

The total number of attendances at the Lister over four hours, in the same three month quarter, was almost 7,400, over two times what it was one year prior.

All information has been sourced from NHS England.

When Trident Media contacted East and North Hertfordshire NHS Trust for comment, the Chief Executive, Nick Carver, said that, nationally, the NHS is struggling to meet A&E targets:

“The NHS as a whole has struggled to meet this standard consistently since September 2014, following changes in both the level of A&E attendances and the numbers of frail elderly patients brought in by emergency ambulance to hospitals across the country.

“The challenging performance picture facing the NHS nationally has also been seen locally here in Hertfordshire.

“Although the Lister’s new £19 million emergency department – which saw its capacity doubled – when it opened fully in October 2014 – offers a great service, it has seen a significant arise in very ill elderly patients, often with multiple and complex health needs, being brought to the Lister by emergency ambulance.

“Over recent weeks in particular attendances have breached 500 a day, which has impacted on waiting times for those with conditions and injuries that are not life-threatening.  In turn, this has contributed to the Trust missing its A&E waiting time performance – although it has improved since December 2015 when a recovery trajectory was agreed with the NHS Trust Development Authority.”

Carver went onto explain that: “Winter is one of the busiest times of the year for NHS hospitals when it comes to emergency care…” and that, “The parts of the Trust that takes the brunt of these pressures include A&E…

“Prior to the changes made to the Lister and QEII back in 2013/14, the Trust had some 750 beds across the two hospitals; today it has around 720 just at the Lister… The emergency department at the Lister has doubled its capacity and physically is three times the size of the old A&E.”

Image: Leon Brocard, Flickr, CC BY 4.0
Image: Leon Brocard, Flickr, CC BY 4.0

Carver continued, saying: “The Lister’s emergency department has been exceptionally busy over recent weeks – in December, 80.5 per cent of those attending were seen, treated and either admitted or discharged home within four hours of their arrival.  The standard we are expected to reach is 95 per cent, although the Trust’s performance was broadly at the average for the NHS as a whole that month.”

However, Carver’s statistics are misleading. According to NHS England statistics, in the month of December 2015 the A&E Unit at the Lister only treated 71.9 per cent of patients within four hours and the 80.5 per cent figure (in reality 81 per cent) applies to all hospitals within the East and North Herts NHS Trust, i.e. the A&E at the Lister as well as the UCC at the QEII.

As well as this, Carver’s statement that the Trust performance was “broadly at the average” for December 2015 is also factually unsound; the average performance of major A&E units across England was in fact 86.6 per cent, and across all types of A&Es (including UCCs) in England that figure rises to 91 per cent. This means that East and North Herts NHS Trust is 14.7 per cent and 10 per cent away from the respective national averages.

Carver also added that: “No one waited more than 12 hours once the decision to admit them was made.”

In response to the claims that problems with waiting times were caused by the transfer of A&E services at the QEII to the Lister, Carver said: “If the changes had not been made, then we would be in a far worse position.  We would have had too few staff spread too thinly across both sites; we also would not have had the investment into the Lister’s emergency department.  Quite simply without the changes, we would not have been able to cope.”

Image: Ilmicrofono Oggiono, Flickr, CC BY 4.0
Image: Ilmicrofono Oggiono, Flickr, CC BY 4.0

When asked for comment, leader of the Welwyn Hatfield Borough Council, Conservative John Dean, expressed deep concern with the figures, commenting that since the closure of the A&E service at the QEII, residents had lost their “peace of mind of knowing that they can get treated nearby.”

Dean also went on to add: “[I] knew it [A&E service] was bad, but [the NHS’s/Trident Media’s] figures prove it.” Dean later said that he found the targets consistently not being met, “disturbing”.

When asked for comment, Kieran Thorpe, leader of the Labour opposition on Welwyn Hatfield Borough Council, launched an attack against the local Conservative party and MP, Grant Shapps: “Residents of Welwyn Hatfield have for the last decade been fed a lie very cleverly by their MP Grant Shapps, that it was the then Labour government that closed their hospital.”

He attacked again, saying there had actually been a, “collusion of local Conservative politicians that signed-off on this move, with the actual closure taking place two years after Mr Shapps was re-elected on a cast iron promise that he would ‘save the A&E at the QEII.’

“…once elected as part of the coalition [the Conservatives] set about closing A&E at Chase Farm Hospital in nearby Enfield. Tell a lie often enough and it becomes accepted as fact.”

Thorpe went on to advise a call to action: “Urgent action needs to be taken to meet the health needs of local residents and students alike. An increasing population requires an increase in healthcare provision and I am convinced that Hertfordshire needs another fully fledged hospital with full A&E services and that it should be built in Welwyn Hatfield.”

East and North Herts NHS Trust currently have no plans of restoring the full A&E service at the Queen Elizabeth II Hospital or building a new one to cope with increasing demand. The NHS statistics show that the Lister is not coping with the continued demand and strain of the growing population of Welwyn Hatfield and the rest of East and North Hertfordshire.

The full statement from Nick Carver can be read online here.

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Local hospitals fail to meet A&E waiting time targets since closure of A&E in Welwyn Garden City in 2014