Health managers are warning of waiting times of up to 12 hours at Harrogate District Hospital’s emergency department.

West Yorkshire Association of Acute Trusts, which is a partnership of six hospital trusts including Harrogate, has urged patients to only attend the department for life-threatening injury or illness.

Hospital officials have warned that some patients are waiting as long as 12 hours for treatment.

Latest figures show that Harrogate District Hospital had 4,595 attendances to its emergency department in February 2022.

The national standard for emergency department waiting times is to admit, transfer or discharge 95% of patients within four hours.

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According to NHS England figures, 65% of patients were seen within that time at Harrogate hospital.

Dr Andrew Lockey, consultant physician in emergency medicine with Calderdale and Huddersfield NHS Foundation Trust, which is one of the six trusts that belong to West Yorkshire Association of Acute Trusts, said: 

“It’s really important that people only come to an accident and emergency department if they really need to. Our hospitals are extremely busy, and people are having to wait a long time to be seen.

“Over the past two weeks we’ve faced huge challenges with the sharp uplift in the number of people attending accident and emergency. This places additional pressure on our teams who are responsible for treating patients with serious and life-threatening conditions.

“If you are unwell and are unsure which healthcare service you need, call NHS 111. A highly-trained clinical advisor will direct you to the most appropriate service.”

An inquest into the death of a Harrogate woman has concluded that no single factor contributed to her taking her life.

Sarah Tatlow, 57, died at home on March 26 last year. At the time of her death she was undergoing treatment for an aggressive form of cervical cancer.

The two-day inquest in Northallerton, which ended today, heard Ms Tatlow’s husband, Julian Tatlow, question the actions of her doctors in the months leading to her death.

Mr Tatlow said his wife only became fully aware of her “poor prognosis” when a letter was sent days before her death.

The letter was written by Dr Isa Edhem, a consultant urological surgeon at Harrogate District Hospital, to Ms Tatlow’s GP practice. Mr Tatlow described the letter as “cold and insincere” and said it contained details not made clear to them during their consultation with Dr Edhem.

Harrogate District Hospital.

Mr Tatlow questioned members of his wife’s care team during the inquest, asking if they had made it clear to her how aggressive her cancer was. The doctors said they were sure Ms Tatlow knew her cancer was aggressive.

The coroner, Oliver Longstaff, said he took Mr Tatlow’s arguments into consideration but that there was no evidence the letter had a direct link to Ms Tatlow’s death.

Mr Longstaff concluded:

“Since it’s not known when that clinical letter arrived and indeed whether she had seen it, it is inappropriate for me to consider that a direct causal link can be found.

“Even if the letter arrived on March 26 and even if she had taken in the content, is there evidence this letter provoked her suicide over other factors?

“She was facing drastic surgery. I find it unrealistic to single out one factor only and say one was a trigger to this tragedy.”

He concluded the death was due to suicide and there was a clear link to her cancer.

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Hospital action plan

Mr Longstaff then read out an action plan written by Dr David Earl, on behalf of Harrogate and District NHS Foundation Trust, setting out a number of recommendations the hospital had put into place following Ms Tatlow’s death.

These included a protocol whereby, rather than sending letters to a patient’s GP, they are sent directly to the patient, explaining their prognosis and management plan. This is due to be rolled out across all departments by autumn this year.

It also suggested doctors would be more proactive with referrals to the cancer clinical psychology team if patients are struggling to cope.

Mr Longstaff said the trust’s action plan meant there was no need for him to write to the trust outlining his own recommendations.

Dr Jacqueline Andrews, executive medical director at Harrogate and District NHS Foundation Trust, said in a statement afterwards:

“We would like to offer our deepest sympathies to the family and friends of Sarah Tatlow, and our thoughts are with them at this difficult time.”

Harrogate care home managers have warned the staffing crisis is only getting worse and that it will inevitably cause more bed blocking problems for the NHS.

Sue Cawthray, chief executive of Harrogate Neighbours, described the current situation as “dire” and said she has “never known it as bad as this”.

She said:

“The sector is desperately short of care staff.

“At Harrogate Neighbours we can’t increase our packages for home care and we are struggling to keep our care home above water, with staff having to work extra time to cover spare shifts.”

Susie Harrison, manager at Highgate Park care home and chair of Harrogate and District Registered Managers Network, also said the staff shortages were the “underlying cause” of delays in discharging hospital patients into care homes.

She said: 

“Care homes can’t take any more residents because they don’t have the staff and this means people end up stuck in hospital – that is the reality of the situation.”

Hospital can’t discharge patients

Harrogate District Hospital has confirmed it currently has around 40 patients who no longer require hospital care but can’t be discharged because they do not have a suitable location to continue their recovery.

This latest figure comes after the hospital recently warned it was “very full” and that this was having an impact on waiting times.

As well as the social care staffing shortages, Dr Matt Shepherd, deputy chief operating officer at Harrogate and District NHS Foundation Trust, said covid is also playing a “big part” in the bed blocking problems.

He said: 

“When care homes have had to close due to covid outbreaks, or the service they provide has been affected due to their staff being unable to work after catching the virus or having to self-isolate, we have been unable to discharge patients into their care.

“We know how being in a more familiar location can aid recovery and we are working closely with our partners in social care to ensure patients who no longer require hospital care are able to be discharged as soon as possible.”

There are currently around 1,000 vacant care jobs across North Yorkshire and a recruitment campaign has been launched by North Yorkshire County Council to try address the shortfall.

Make Care Matter campaign

Make Care Matter aims to change perceptions about working in the sector which has endured a major challenge to attract and retain staff long before the current crisis.

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Since the campaign launched in January, 268 job applications have been progressed, with 197 interviews resulting in 91 job placements.

Senior officials at the county council have said this shows some progress has been made, although they added it will take more than a recruitment campaign to solve the staffing problems.

Richard Webb, corporate director for health and adult services at the county council, said government promises to reform how social care is funded and how much staff are paid will be the key.

He said: 

“We have seen a step-change in the care market since summer 2021, with very tough competition in the labour market, which is having a significant impact on care providers being able to recruit.

“The county council and the NHS have put additional funding into the sector to help sustain services, manage covid-19 and, recently, to support the workforce, including a one-off pay bonus for 16,000 care workers.

“Whilst the council welcomes the government’s proposals for changing how much people pay for care, we also want to see national action to help stabilise care providers and to improve the pay and status of care workers.

“In the meantime, we work closely with our care providers and NHS colleagues to ensure that as many people can go home from hospital as soon as is safe and feasible to do so.”

Hospital bosses in Harrogate have warned that the number of patients requiring treatment for winter infections remain high.

Dr Matt Shepherd, Deputy Chief Operating Officer and consultant in emergency medicine at Harrogate and District NHS Foundation Trust said bed occupancy at the hospital remains high at 90%.

The hospital is currently dealing with patients suffering from winter infections, such as flu and coronavirus. Health officials in Harrogate recently urged people to dial 101 if their illness or injury was not serious.

According to the NHS England figures, the hospital is also treating 25 covid patients.

This comes as the district’s seven-day covid rate stands at 417 per 100,000 people, with a total of 880 covid cases in the last seven days.

Dr Shepherd said historically, pressures tended to ease during the spring. But this was now uncertain due to coronavirus and the lack of national restrictions.

He said:

“Historically, as we approach spring, the pressures have tended to reduce, however, as we are still dealing with the covid-19 pandemic this is not certain.

“Currently bed occupancy at our hospitals remain high at around 90 percent, a similar figure to February.”

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Dr Shepherd added that the pandemic was also having an effect on waiting lists. He said:

“The covid-19 pandemic certainly impacted on waiting lists for operations and one of our major priorities has been to cut the backlog.  

“The increased number of planned operations that are being performed has meant we have more patients occupying beds following their surgery.”

Dr Shepherd said the hospital also had 40 patients who no longer required care, but cannot be discharged because they do not have a suitable place to return to in order to recover.

Despite the continued pressures from covid, the hospital has since relaxed its visiting restrictions.

However, those visiting the hospital will still be required to wear a mask, sanitise their hands and abide by social distancing.

Dr Shepherd said:

“We are pleased to have recently been able to relax visiting restrictions, but anyone entering our hospitals will still need to wear a mask, ensure they sanitise their hands and maintain social distancing.  

“Following these protocols will help us to protect our patients, but also our staff. Reducing the risk of our staff catching covid-19 will help us to maintain appropriate staffing levels so our patients’ care is not disrupted.”

Sir Robert Ogden, the self-made businessman and philanthropist who opened a cancer centre at Harrogate District Hospital, has died aged 86.

Sir Robert made his fortune in the mining, quarrying and building industries and donated to charities, in particular those connected to cancer care.

He was also a leading racehorse owner and co-owned See More Business, which won the Cheltenham Gold Cup and the King George VI Chase at Kempton Park.

Born in Wibsey, Bradford, in January 1936, Sir Robert was the eldest of six children. His father Albert was a master builder.

He lived in Sicklinghall, near Wetherby, where he kept his stables.

In 2001, he was awarded a knighthood for his services to charity which included the opening of the Sir Robert Ogden Macmillan Centre at Harrogate District Hospital.

The centre was opened in March 2014 and continues to offer cancer treatment and health and wellbeing services to patients today.

We're very sad to hear Sir Robert Ogden has passed away. We're eternally grateful for his generosity – it helped us to establish the Sir Robert Ogden Macmillan Centre at our hospital. Thank you Sir Robert for your support. Our thoughts are with his family and friends. pic.twitter.com/NwAGA5bBnG

— Harrogate NHS FT (@HarrogateNHSFT) March 9, 2022

The hospital said:

“We’re very sad to hear Sir Robert Ogden has passed away. We’re eternally grateful for his generosity — it helped us to establish the Sir Robert Ogden Macmillan Centre at our hospital.

“Thank you Sir Robert for your support. Our thoughts are with his family and friends.”

South Tees Hospitals NHS Foundation Trust, which runs a similar centre in Northallerton opened by Sir Robert, also paid tribute to him.

A spokesperson said:

“Sir Robert was a huge supporter of charities and generously helped improve cancer services in the region.

“We’ll always be grateful for his support. Our thoughts are with his family at this difficult time.”

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Successful racehorse owner

As well as charities, Sir Robert was a successful racehorse owner.

His mauve and pink checked silks were carried to victory by horses including Voy Por Ustedes and Exotic Dancer.

He also owned Cheltenham Gold Cup runner-up Exotic Dancer and top horses over the jumps, including Ad Hoc, Marlborough, Star De Mohaison, Fadalko and Squire Silk.

Former jockey and Gold Cup winning trainer, Jonjo O’Neil, paid tribute to Sir Robert.

He said:

“Very sad to hear that Sir Robert Ogden has passed away.

“We enjoyed some incredible days with Exotic Dancer, notably winning the Lexus and a second in the Gold Cup.

“He was a wonderful gentleman who will be sadly missed. My thoughts are with his family and friends.”

Sir Robert died peacefully at home on March 6, 2022.

He is survived by his second wife Lady Ana Ogden and his two sons Adam and Robert from his first marriage.

In memory of Sir Robert, a donation page has been set up at the University of Leeds to help support research into brain cancer. You can donate and find more information here.

From Tuesday, the rules for people visiting patients in Harrogate and Ripon’s hospitals will be relaxed following a decline in covid infections.

On December 23, Harrogate and District NHS Foundation Trust tightened visitor restrictions because of the Omicron variant and the subsequent rise in infections. At one point the Harrogate district had the highest covid rate in North Yorkshire.

Visitors were only allowed for patients on end of life care, patients with a learning disability or severe cognitive impairment such as dementia. Parents or carers of children and birthing partners were also permitted.

But from Tuesday, patients can have one visitor, by appointment, between 2-4pm for 30 minutes.  Only two visitors will be allowed in each bay at any one time.

Visitors are asked to book appointments by phone from Monday.

Bookings should be made directly with the ward where a patient is staying.

For Harrogate District Hospital call 01423 885959. For Ripon Community Hospital call 01423 542900 between 10am and 4pm and ask to be put through the relevant ward.

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Also from Tuesday, outpatients will be allowed to have one person accompany them to a hospital appointment.  All visitors will have to wear a mask and sanitise their hands when they arrive.

Harrogate hospital managers warned yesterday that “high numbers of very sick patients” is causing long waiting times.

They added that people with less urgent issues are experiencing long waits.

The news comes weeks after Harrogate and District NHS Foundation Trust reported that it had reached maximum bed capacity at the start of February due to covid and winter pressures.

In a post on its social media, the trust urged people to call the NHS on 111 unless they had a life-threatening or severe illness or injury.

It said:

“During this week at Harrogate District Hospital we are experiencing high numbers of very sick patients, and due to this the hospital is very full. As a result, patients with less urgent issues may experience longer waiting times than usual.

“This isn’t ideal and we will endeavour to keep waiting times as short as possible. We know that patients can be in pain, stressed or scared, and our dedicated team with do everything they can to help.

“Your health is our utmost priority and all we ask for in return is our staff are treated respectfully and do not have to face verbal or physical abuse as they try to do their job.

“Unless you have a life-threatening or severe illness or injury, we would ask you to contact NHS 111 first.”

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Steve Russell. chief executive of Harrogate and District NHS Foundation Trust, is to take up a secondment as national director for covid and flu vaccinations at NHS England.

Mr Russell will replace Dr Emily Lawson in a role that could last up to a year.

He will leave the trust for the time being on Friday next week.

Steve Russell

Angela Schofield, chairman of the trust, which runs Harrogate District Hospital and Ripon Community Hospital, said in a statement today:

“Steve’s new role will take him away from HDFT for at least six months and potentially up to a year.

“I know that, while he is looking forward to this new opportunity, he is eager to return to HDFT.

“We are very fortunate to have a strong executive team and board, which has meant we have the resilience in place that has allowed Steve to take up this opportunity.

“While Steve is away we need experienced leadership to maintain our progress and I am delighted to let you know that Jonathan Coulter, who is currently deputy chief executive and our director of finance, will become acting chief executive, and Jordan McKie, our deputy director of finance, will take up the role of acting director of finance.

Jonathan Coulter

Mr Russell announced the move on Twitter this afternoon.

https://twitter.com/steve_r76/status/1494330025524416518

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Almost 800 Harrogate District Hospital patients were allowed to return to their care homes without being tested for covid, it has been revealed.

Figures obtained by the Local Democracy Reporting Service provide the clearest picture yet on how patients were moved between the hospital and care homes – a practice which is believed to have fuelled infections amongst the most vulnerable.

The figures show a total of 788 patients were discharged into care homes without being tested between March 2020 and November 2021.

But the hospital says it has followed national guidance on when to carry out tests and that “patient health and safety is our primary concern”.

It also said the figures will include patients who were tested before arriving at the hospital, although it added “we do not record this information”.

Russell Nightingale, chief operating officer at Harrogate and District NHS Foundation Trust, said: 

“During the covid pandemic, steps were taken to ensure patients could continue to be looked after in a safe environment – this was especially important for vulnerable and elderly people.

“A policy was introduced on April 15, 2020, requiring inpatients who were being discharged from hospital to a care home to have a covid test.

“Only patients who had received a negative covid test were discharged.

“If they tested positive, infection prevention measures were put in place for the individual to prevent the virus from spreading and so that the patient could be treated appropriately.

“They would remain in hospital for the required period before they were discharged.”

However, this approach did not apply to patients attending appointments or the emergency department who were allowed to return to their care homes without being tested.

And crucially, the testing of inpatients was only introduced by the government in April 2020 – almost three months after the first covid case was detected in England and when there was no protection from vaccines.

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It is thought covid was transmitting at a much quicker rate than was known at these early stages in the pandemic, and once inside a care home it often spread to residents with devastating consequences.

410 care home deaths in North Yorkshire

Since the start of the pandemic, a total of 410 covid deaths have been reported by North Yorkshire care homes which have had to deal with PPE and testing shortages, as well as ever changing government guidance on visiting restrictions.

Harrogate hospital said it was not impacted by the testing shortages.

But Harrogate and Knaresborough MP Andrew Jones said the government did recognise there were “challenges” with testing as he also praised staff at the hospital for their efforts during the pandemic.

Mr Jones said: 

“It seems clear to me that the staff at Harrogate hospital sought to deal with patients in the safest and most practical way during the pandemic.

“This must have been extremely difficult for them particularly in the early days of the pandemic when the world was fighting against something new and about which medical science knew little but could see it was deadly for many.

“There were also challenges with protective equipment supply, testing capability was still limited and hospitalisation rates were high.

“The description they have given about their testing regime would seem to most people to be practical and credible with patient safety at its heart.

“I want to again put on record my thanks to the clinical staff and also to the non-clinical support staff for ensuring the highest standards of patient care in unprecedented circumstances.”

Harrogate and District NHS Foundation Trust has paid consultants £82,000 to investigate concerns of a “culture of bullying” within the organisation.

Deloitte was commissioned for £30,000 to examine concerns about leadership and culture at the trust and Harrogate Integrated Facilities, a a wholly-owned subsidiary that supplies services to Harrogate District Hospital and community services.

A 2018 national NHS staff survey, a British Medical Association member survey and the trust’s own ‘fair and just culture’ diagnostic had triggered concerns.

After it found issues in some areas of the service, the trust commissioned Deloitte for a further £52,000 to undertake a detailed review of leadership and recruitment practices at HIF which was published at a trust board meeting in June 2020.

Deloitte’s report said some staff described the culture at HIF as “toxic”. It cited cases of people being ignored or ostracised, belongings defaced with offensive graffiti and people’s lockers and equipment being glued.

£82,000 culture review

The initial review included interviews with 52 members of staff and 63 surveys. It found “widespread concerns” over bullying, leadership and poor recruitment practice at HIF.

The report said a “significant number” of those interviewed explicitly stated that bullying was taking place or described events that could be labeled as such. It added some of the reports were dismissed as “banter”.

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Deloitte also found that the approach to recruitment at HIF “did not demonstrate good practice” and recommended a thorough review of its policies.

As a result, the trust launched a formal investigations into the findings.

Trust ‘confident’ it has addressed report findings

The Stray Ferret asked the trust how it had addressed poor recruitment at HIF and whether any staff members were disciplined as a result of the investigation.

The trust said it was confident its recruitment policy complied with company policy and that it had addressed Deloitte’s findings.

Steve Russell, chief executive of HDFT, said:

“In 2018, we conducted a staff survey which showed that whilst staff at both HDFT and our subsidiary company Harrogate Integrated Facilities generally had positive experiences, there were some experiences that were not in line with the trust’s values.

“We felt that a more detailed assessment of culture at HDFT and HIF was required to help us to understand the issues. It was important that the assessment was independent, objective and avoided conflicts of interest to ensure we had an accurate picture of what we were doing well, but more importantly what we needed to improve on.

“Deloitte was commissioned at an initial cost of £30,000 to undertake the assessment. This revealed a number of issues that needed to be addressed in a small number of services, and we decided therefore to commission a second piece of work from Deloitte at a cost of £52,000, which explored in much greater detail the areas of concern that had been identified.

“The concerns have been treated as a matter of priority. An investigation into the issues identified within our radiology department was undertaken by two experienced people who were independent of the trust and each other. Their finding and recommendations have been used to improve the environment for our staff.

“A formal investigation into allegations and harassment in estates and HIF was undertaken by colleagues within the trust. A capacity and capability review of leadership in HIF was also conducted by an independent, experienced NHS director of estates and facilities. This review has led to changes within the company. We are confident that recruitment practices now comply with the company’s policy.

“There are a number of other changes we have made in line with the plan we published at the time of the Deloitte review to improve the experience of colleagues who work here and this work will continue.”