Harrogate and District NHS Foundation Trust is to spend £900,000 on an emergency department streaming service aimed at reducing waiting times.

Under the plans, Harrogate District Hospital patients will be assessed on arrival at A&E.

If they have a less serious illness or injury will be transferred to another part of the hospital, which will have its own designated clinical practitioners.

Hospital officials said this will allow the emergency department to “focus on patients who require urgent stabilisation, resuscitation and/or further assessment in our hospital”.

As part of the £900,000 spend, new staff will be hired and enhancements made to the existing department.

The trust said the streaming model will be introduced gradually over the next four to six months as training and building work takes place. It aims to have the new system fully operational by winter this year.

A spokesperson for HDFT said:

“The streaming model in the emergency department at Harrogate District Hospital is focused on improving the experience and timeliness of care for patients attending the emergency department.

“It will help us to reduce delays and some of the pressure in the main emergency department, which is a significant area of concern for all trusts.

“Patients arriving at the emergency department will be rapidly assessed and if they have a less serious illness or injury they will be transferred into the new stream which will have its own trained clinical practitioners with injury and minor/moderate illness skills.

“This will allow the main emergency department to focus on patients who require urgent stabilisation, resuscitation and/or further assessment in our hospital.”

Long waiting times

Latest figures show that Harrogate District Hospital had 4,331 attendances to its emergency department in April 2022.

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

Harrogate District Hospital

According to NHS England figures, 66% of patients were seen within that timeframe at Harrogate hospital.

In April, West Yorkshire Association of Acute Trusts, which is a partnership of six hospital trusts including Harrogate, urged patients to only attend emergency departments for life-threatening injury or illnesses.

Dr Andrew Lockey, consultant physician in emergency medicine with Calderdale and Huddersfield NHS Foundation Trust, which is part of the association, warned that units were “extremely busy” with waits of up to 12 hours.

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Officials at Harrogate hospital hope that the new streaming model will help to relieve pressure on the department.

The move comes as other hospital trusts across the UK have introduced similar measures.

In 2018, United Lincolnshire Hospitals Trust spent £500,000 on expanding Boston Pilgrim Hospital’s emergency unit in order to introduce a streaming service.

At the time, ULHT said it felt there were too many patients attending the emergency department who could be seen by a general practitioner instead.

Harrogate District Hospital has confirmed that it has not treated any cases of Monkeypox.

The UK Health Security Agency has reported 172 cases of the virus in England so far.

The virus, which originated in Africa, causes a mild infection and is spread through contact with scabs on the skin, bedding and towels used by an infected person.

It can also be transmitted through coughs and sneezes from those who have been infected.

A spokesperson for Harrogate and District NHS Foundation Trust confirmed yesterday it had not treated any patient with the disease.

However, they added that the trust had taken precautions to prevent the spread of Monkeypox within its hospitals.

A spokesperson for the trust said:

“Monkeypox is quite difficult to pass on unless in close contact, and tends to happen through broken skin, although it can happen through a cough or sneeze if you are in close proximity.

“In this respect the same precautions that we introduced during the covid pandemic and that are still relevant for visitors to our hospital today are relevant for monkeypox — anyone visiting the hospital still wears a mask, washes/sanitises their hands frequently, and maintains social distancing where possible together with ensuring good ventilation.”

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Meanwhile, the UK Health Security Agency has not confirmed any cases of the virus within Yorkshire.

The public health body added on its website that the majority of cases confirmed had been found in gay and bisexual men. But it stressed that the disease is not sexually transmitted.

The UKHSA said:

“The risk to the UK population remains low, but we are asking people to be alert to any new rashes or lesions, which would appear like spots, ulcers or blisters, on any part of their body.

“Although this advice applies to everyone, the majority of the cases identified to date have been among men who are gay, bisexual and men who have sex with men, so we are asking these people in particular to be aware of the symptoms, particularly if they have recently had a new sexual partner.”

The chief of Harrogate District Hospital has warned problems in the care sector are making it “really difficult” to discharge patients who are well enough to leave.

Official figures show the number of patients who have been in the hospital for more than 21 days has almost doubled from 48 in April 2021 to 83 last month.

Jonathan Coulter, acting chief executive of Harrogate and District NHS Foundation Trust, told a board meeting today a shortage of care home beds and staff were causing the delays to discharging some patients.

He said the continued impact of covid was also having an impact:

“There are capacity constraints all the way through the system, from being able to staff care homes effectively and appropriately through to social care packages.

“All of these things mean people are not leaving hospital even though it is a less safe place for them to be.”

Mr Coulter also said the delays were causing problems for the flow of patients through the hospital from arrivals to discharges.

Harrogate District Hospital

He explained the hospital was working with the care sector to tackle the delays and that other internal action was being taken, including a week-long event to speed up the system.

He added the hospital was continuing to recruit new staff and had committed funding to improve its emergency department:

“The whole pathway is under pressure. It is challenging… but we have got a plan and are sticking with it. The important thing is that we don’t tolerate or normalise where we are at the moment.

“It is also really important that we tackle the improvement work in a really positive spirit.”

Mr Coulter said the pressures across the health and care system were still being exacerbated by covid, although the position was “much improved” from earlier in the pandemic.

He also said the reduction of the covid alert level from level four to three last week marked a “massively important step” for the NHS.

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Harrogate hospital currently has 15 covid patients, while staff absences as a result of the virus have dropped from over 200 earlier this year to the current position of around 70.

Meanwhile, the district’s weekly infection rate currently stands at 93 covid cases per 100,000 people – its lowest level since at least last September.

At its peak, Harrogate Scrubbers had 800 members making scrubs for hospital staff during the first covid lockdown. The group worked frantically and in just six weeks, 2037 scrubs were handed over to front line staff at Harrogate District Hospital.

It was an extraordinary community response to a health crisis and a serious shortage of PPE supplies.

To celebrate and remember their achievement, scrubbers were invited to sew a square of fabric for a quilt. Each was asked to detail what it meant to them to be part of the sewing group.  The squares have been made into five beautiful quilts. The scrubbers founder, Fran Taylor, has also created a book with photos of the squares and each group member’s memories.

Tonight, the group will gather at the Pavilions of Harrogate to see the quilts on display in what is expected to be an emotional event.

Fran explained,

“The experience of being part of the Harrogate Scrubbers meant so much to so many people, that we wanted to commemorate the groups achievements, and also give everyone something to remember for the part they played supporting the NHS in the pandemic”

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One of the five completed quilts (above) and below an excerpt from Fran’s book. 

Lisa Sumpton from Harrogate, who two years ago was in charge of logistics for the scrubbers, said:

“It’s just nice to see all the squares that have been lovingly made by individuals- to represent a moment when a community came together to something good at a time of great uncertainty”.

The contribution the scrubbers made to support the NHS and its staff locally has not been forgotten.

Sammy Lambert, the business development, charity and volunteer manager for Harrogate and District NHS Foundation Trust said:

“It does feel surreal two years on. Unless you lived through the time and felt the community spirit, it’s hard to explain.

“We’d like to say a huge thank you to Fran and all the scrubbers for helping us to do our jobs at such a difficult time”

Tonight the scrubbers will come together, many having formed friendships through the project, they’ll raise a glass to each other and be formally thanked by Sarah Armstrong, Chair of Harrogate Hospital Trust for their wonderful work during the pandemic.

Forty years on from her diagnosis, a woman has set up a Harrogate Lupus support group for local people to find support and hopefully comfort in hearing the experience of others.

Cherry Bratkowski was 23-years-old when she was diagnosed with the autoimmune disease. She’s now 61-years-old and over the years has experienced severe fatigue, rashes, liver and brain inflammation and numerous cases of pneumonia.

A main motivator for setting up the group for her was having to go through years of hospital admissions with her daughter, Tess Bratkowski, before she got an autoimmune diagnosis at 26-years-old.

Similar to her mum, Tess developed symptoms from the age of 12 but it has taken years of letters to MPs and consultants to get the right referral.

Tess Bratkowski

Ms Bratkowski is a professional musician and the resident pianist at the Old Swan, Harrogate. She said her diagnosis meant she couldn’t follow her original career path because she was too ill.

She knows other people will have similar experiences and hopes they could find comfort in sharing them with others:

“I’ve been very lucky in a lot of ways, I was told it was 80% unlikely that I could carry a child but I had two. But I’ve also been very ill, I just feel like there needs to be a lot more awareness.”

Lupus is thought to affect one in every 1,000 people but with no specialist lupus nurse at Harrogate District Hospital she believes there isn’t enough support.

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She said she had wanted to set up a group after the previous Harrogate group disbanded.

The musician plans to hold meetings at Woodlands Methodist Church Hall, with the first next Tuesday, May 24, between 1pm and 3.30pm.

Ms Bratkowski has worked with national charity Lupus UK to set up the group and hopes to encourage people across the district to attend.

She added:

“Watching my daughter brought it home to me how many people are suffering, whether its their medication side effects or isolation during covid it’s been very difficult for us.

“The help just isn’t there, people just don’t know enough about it even doctors and specialists.”

To contact Ms Bratkowski about the meeting, email Organpipe@icloud.com.

When Kim Ellis had back pain on the last day of her Lanzarote holiday, she thought she was just unwell.

She was only 26 weeks pregnant, so it didn’t even enter her head that she might actually be going into labour.

Just over 24 hours later, on October 12, 2021, her “miracle baby” Ava was born, weighing a tiny 1lb 15oz.

She said:

“You worry about miscarrying, but you never think your baby could come that early. It didn’t even enter my head.”

Baby Ava in hospital.

Last weekend the brave little girl was christened in Harrogate, surrounded by her family and friends.

More support

Now, Kim is calling for more support for mums who have had premature births.

The hairdresser, who owns Blossom Hair, based at the Wellness Rooms, on Cold Bath Place, said:

“It is actually such a big thing, but not always something that is really talked about.”

When I met Kim for a coffee, I was in awe of this incredibly resilient mum who had clearly been through so much.

After cooing over a sleeping Ava for five minutes, we started chatting and I learned that her story actually began in the January lockdown of 2021.

Dating website

Kim explained that she had met her partner Connor Stewart on dating website. After chatting, they decided to meet up for a walk in the New Year, just a day before the third national lockdown.

She said:

“We were in our own little bubble then. So we decided to carry on meeting up for walks, chatting and FaceTiming. So really we got to know each other quite well, because there was nothing else to do.

“We made all these plans to go on holiday and do all sorts of things.

“Then in May I found out I was pregnant. It was a complete and utter shock, as we had literally only been together for about three months.

“We discussed everything and said ‘let’s just do this’. As we weren’t even living together at that point, he moved in with me and we started preparing for the baby.”

Back Pain

When restrictions were eased in October last year, the couple decided to book a short break to Lanzarote, one of the Canary Islands.

Kim said:

“We flew on October 6. I had been checked out and was about to go into my 25th week.

“We had a great holiday. Then on our last day, I started getting a bit of back pain.”

Kim realised she could barely walk up the steps to their room.

She said:

“The baby wasn’t due until January 16, so I was wondering how I was going to cope until then. I felt like she was so low down, she was going to drop out!”

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What she thought was back ache, actually turned out to be contractions, which started to come on thick and fast during the night.

She said:

“I could feel her moving the whole time, so I wasn’t concerned at all. I just thought it was me.

“But then it continued and there was definitely a pattern. It got to 2am, so I rang Harrogate Hospital to ask for advice. They thought it could be a urine infection.”

At around 8am, Kim noticed she had started bleeding. As the baby was still moving, she believed there was something wrong with her, so she decided to visit a medical centre near the hotel.

She said:

“Poor Connor didn’t have a clue what was going on. Covid rules were so strict over there, he was kept away from me.”

After being taken by ambulance to the main hospital on the island 40 minutes away, Kim was relieved to be met by a huge team of midwives and doctors.

4cm dilated

However, her relief was quickly replaced with shock when she was told she was 4cm dilated.

She said:

“They were really positive, as obviously I was only 26 weeks. But they weren’t sure if the baby would have any health problems. However, they said she seemed really strong.”

After being given medication to stop her contractions, Kim was taken to a bed to get some sleep.

But then her waters broke.

‘So strong’

She said:

“It was now Tuesday morning, it was 10am and I was 7cm. I stayed 7cm all day, so then they had to put me on a drip to try and induce me.

“I just got set up with gas and air when I was told I needed to push.

“They had to be careful how to deliver her as she was so small. But she was ready to arrive. She was in the right position. She was so strong, she didn’t get distressed.

“They told me not to be be alarmed if she didn’t cry as she had weaker lungs. But when she came out she was crying and looking around at everybody.”

Kim cuddles tiny baby Ava at the hospital in Lanzarote.

Ava was then taken away and put on a ventilator ready for both mum and baby to be airlifted to a larger hospital on Gran Canaria, which had more facilities.

However, the doctors discovered Kim had been bleeding, so she was whisked off to theatre.

This meant that Ava was flown to hospital without her mum.

Kim said:

“I got to see her for about 10 minutes before she got transferred to Gran Canaria, which was really hard. But I was just so relieved she was going to get the care she needed.”

Ava is airlifted to Gran Canaria.

Just under two days later, quite remarkably, Kim boarded a standard passenger flight to Gran Canaria to be reunited with Ava.

Adrenaline

She said:

“I don’t know how I did it. I just wanted to get to my baby. It was total adrenaline.

“It was so amazing to see her, but it was hard as she had lost weight. However, she was doing really well and wasn’t on a ventilator.

“Apart from two blood transfusions, she just did so well.

Kim stayed on the island by Ava’s side for six weeks.

She said:

“Connor had to go back to work at Avenue Bakery, in Bilton. He also had to move house for us. So I got out of that one!

“We had to get Ava an emergency passport. I was quite scared to fly her back to the UK. But the plane was like a private jet with an amazing team, which included a neonatal doctor, nurse and two pilots.

“I was so petrified, but it was like a military operation.”

Kim and Eva arrived at Leeds Bradford Airport on November 27, where a bed was waiting for them at St James Hospital.

Harrogate Hospital

After a nine-day stay, when Ava turned 34 weeks, they were transferred to Harrogate District Hospital’s Special Care Baby Unit.

Kim, who said she was extremely thankful to all the midwives, doctors and nurses, said:

“We came out on December 21 just before Christmas, which was lovely. To be honest, I think I was still on adrenaline, as I somehow cooked a massive Christmas dinner.”

Last weekend Ava Lottie Grace was christened at Woodlands Methodist Church, on Wetherby Road, in Harrogate.

Connor, Kim and Ava at the christening in Harrogate.

Kim said:

“I’m absolutely loving motherhood and getting stuck in, despite a scary start.”

More awareness

Kim is now calling for more awareness for premature births and would eventually like to see more support and information provided to mums.

She said:

“You don’t think you are going to give birth to a premature baby, but when you do there are things you have no idea about.

“Ava has two ages, she is 6-and-a-half months old, but actually she should be three-and-a-half months. So her milestones are different.

“It’s hard, because I’m going down that route of knowing when to start the weaning process. There is information out there, but it’s still so new.

“Babies are surviving more now thanks to medical advancements, so I feel like there needs to be more out there.

“No matter how small any change in your body is, you should get it checked out. Even if it’s considered normal in pregnancy.

“I kept looking things up, so in hindsight I think I knew something wasn’t quite right. But as it was my first baby and the midwife didn’t seem concerned, I didn’t think anything of it.”

Kim and Ava.

Dr Hugh Larkin, a retired cardiologist and consultant in acute medicine at Harrogate District Hospital for 39 years, has died.

Dr Larkin, who was 78, died on April 1 following a battle with cancer. He leaves behind wife Lynn, children Hugh, Philip, Samantha, Nicola and Tristan and grandson, Hugh.

He joined the cardiology department at the hospital in 1983 and worked through the pandemic until his retirement in January 2021.

Dr Jacqueline Andrews, executive medical director at Harrogate and District NHS Foundation Trust (HDFT), said:

“Dr Larkin was one of our longest serving consultants, joining HDFT in 1983 and working with us during the covid pandemic where he returned to support his colleagues and patients at a time of great need.

“He was a kind, caring and talented doctor who was highly respected by colleagues and patients and he will be greatly missed. Our sincere condolences to his family and friends at this very sad time.”

Born in 1943, Dr Larkin grew up in Glasgow, joining the navy at 16 years old and before studying Medicine at the University of Glasgow.

On graduation in 1974, Dr Larkin became a resident at the Glasgow Royal Infirmary before working at the Western Infirmary and Sydney’s North Shore Hospital.

Dr David Earl, deputy medical director at HDFT said:

“Hugh was a gentle and kind man. He was a wonderful teacher, who was respected as a colleague and friend, and most importantly by the population of Harrogate itself.”

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Sammy Lambert, business development, charity and volunteer manager at HDFT said:

“Hugh was an amazing person and highly thought of by so many people.  He saved so many lives – including my own father. His passing is such a sad loss, but his legacy will live on not only with the funds raised in his memory, but also through the difference he made to so many people’s lives.”

The Larkin family said in a statement:

“Hugh was a cherished husband and loving father; he was a family man in the truest sense of the word and was happiest when surrounded by his wife and children.

“As a family, we knew how much his work meant to him and we were incredibly proud of everything he did as a doctor. We hope his legacy in cardiology, as well as the positive impact he had on the lives of the people of Harrogate, lives on.”

Dr Larkin’s funeral will take place on Tuesday 19 April at 12pm at Our Lady Immaculate and St Robert’s Catholic Church in Harrogate.

Dr Larkin’s family have asked for donations in his memory to go to the cardiology department at Harrogate District Hospital via a dedicated donation page at https://hhcc.co.uk/hhcc-post/in-memory-of-dr-hugh-larkin/

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.”