Strikes cost Harrogate hospital £1.5m this year

Industrial action has cost the trust which runs Harrogate District Hospital £1.5 million in 2023.

The hospital has been hit by numerous strikes in the last 12 months, with consultants and junior doctors staging walkouts in disputes over pay.

Harrogate and District NHS Foundation Trust said the figure was an “unavoidable cost” as a result of the strikes.

The move comes as NHS England has told hospital trusts to reduce targets for routine care in order to pay for the industrial action.

National health officials have estimated that the 40 days worth of strike action has cost NHS trusts £1 billion.

In a letter signed by Julian Kelly, the chief financial officer for NHS England, and Steve Powis, the national medical director for NHS England, local trusts were told that elective surgery targets would be scaled back.

It said:

“For the remainder of the financial year our agreed priorities are to achieve financial balance, protect patient safety and prioritise emergency performance and capacity, while protecting urgent care, high priority elective and cancer care.”

Currently, Harrogate hospital has 822 people waiting more than 65 weeks for surgery. No patients are waiting longer than 78 weeks.

However, a spokesperson for Harrogate and District NHS Trust, told the Stray Ferret that it does not expect NHS England’s target adjustment to affect its plans to tackle waiting lists.

They said:

“NHS England’s decision to reduce the elective activity target for 2023/24 is not expected to have a significant impact at HDFT.

“At the start of 2023, we had 2,918 patients awaiting surgical treatment who would have waited 65 weeks or longer by the end of March 2024. This number had reduced to 822 patients by November 2023 and we are currently on track to ensure no patient will be waiting beyond 65 weeks by the end of March 2024.

“We will continue to focus on cancer pathways to ensure we are able to get to a diagnosis within 28 days from referral and provide treatment within 62 days.

“HDFT is committed to providing the best possible healthcare for our patients and to ensure they can be seen at the earliest opportunity.”

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Harrogate hospital £20m RAAC repairs a ‘critical building safety issue’, says MP

Repairs work at Harrogate District Hospital to fix crumbling concrete are a “critical building safety issue” which should be funded, a Labour MP has said.

The hospital on Lancaster Park Road requires essential work to repair panels made of RAAC.

RAAC – reinforced autoclaved aerated concrete – made headlines nationally recently after it was found to be a substandard component of many schools and hospitals built between the 1950s and 1990s.

Health officials estimated in September it will cost £20 million to eradicate “crumbly concrete” from Harrogate District Hospital, which was built in the 1970s.

As a result, the hospital trust has bid for funding for the work.

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During a debate in the House of Commons on Monday, Mike Amesbury, Labour MP for Weaver Vale, said hospitals in his constituency were also built with the same material.

Richard Foord, Liberal Democrat defence spokesperson, made an intervention during Mr Amesbury’s speech to raise the issue at Harrogate.

He said:

“I was interested to hear the hon. Member mention RAAC in his speech. 

“I have heard that there is a hospital in Harrogate that needs £20 million of repairs because of RAAC, but the government are requiring that hospital to bid for the funding, rather than just giving it the funding. Does the hon. Member think that is right?”

In response, Mr Amesbury, who is also shadow minister for building safety and homelessness, said:

“I certainly do not. It is a critical building safety issue, and funding should be given according to need, so that is a very well-made point.”

The comments come as Tom Gordon, Liberal Democrat parliamentary candidate for Harrogate and Knaresborough, called on the government to foot the bill for the repairs.

This month, Mr Gordon wrote to the then Secretary of State for Health and Social Care, Steve Barclay MP, to highlight his concerns about the construction panels at the hospital made of RAAC.

Lib Dem candidate calls on government to foot £20m Harrogate hospital concrete bill

The man who hopes to be Harrogate and Knaresborough‘s next Liberal Democrat MP has launched a campaign calling on the government to foot the bill for essential repairs at Harrogate District Hospital.

Tom Gordon, the Lib Dems’ parliamentary candidate for Harrogate and Knaresborough, has written to the Secretary of State for Health and Social Care, Steve Barclay MP, to highlight his concerns about the construction panels at the hospital made of RAAC.

RAAC – reinforced autoclaved aerated concrete – made headlines nationally recently after it was found to be a substandard component of many schools and hospitals built between the 1950s and 1990s.

Health officials estimated in September it will cost £20 million to eradicate “crumbly concrete” from Harrogate District Hospital, which was built in the 1970s.

A survey of hospital properties found 2,500 RAAC panels, and added that remedial works have been completed on 12 “high-risk” panels, with some theatres and corridors in the hospital made safe with props. The report said that further propping might be needed of panels that were in danger of collapsing.

Mr Gordon said:

“Every member of our community relies upon our local hospital, or knows someone that does. It is simply not acceptable that people are receiving care, or trying to work, in an environment where temporary props are require to stop crumbling concrete collapsing above their heads. This is scandalous.

“It beggars belief, the local NHS trust are having to bid for this money from NHS England and there is no guarantee they will get it. Where does this leave our patients, doctors and nurses if the bid is unsuccessful?

“Ensuring that our local hospital is fit for the future is a priority to me and many residents I’ve spoken with. People are outraged.

“The government must act and release the funds to fix this crumbling concrete crisis at our local district hospital at once.”

Residents can add their name to Mr Gordon’s letter to the Secretary of State online.

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Visitors barred from Harrogate hospital after ‘security incident’

Harrogate District Hospital suspended visiting yesterday due to a “security incident” in the car park.

Harrogate and District NHS Foundation Trust urged people not to visit the emergency department unless it was a severe illness or injury or a life threatening condition in a social media post yesterday evening. It said:

“We are aware of a security incident in the car park at Harrogate District Hospital and are working with the police who are in attendance.

“Please avoid our Emergency Department unless it’s a life-threatening or severe illness or injury.”

Officers from North Yorkshire Police attended the scene and resolved the situation. A police spokesperson said:

“We were called to Harrogate District Hospital at 3.40pm on Thursday following concerns raised about a patient’s car in the main hospital car park.

“Following enquiries, it was confirmed there was no risk to the hospital or the wider public and the matter was resolved without the need for evacuations of patients and staff.”

The hospital trust did not reveal further details of the incident and a spokesperson said they could not add any more detail to the police statement.

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York hospital defends sending ambulances to Harrogate

York Hospital has defended sending around 1,500 ambulances to Harrogate District Hospital over the last 18 months.

When York’s emergency department is under pressure, the hospital asks for support from surrounding hospitals with capacity, often at short notice.

Harrogate has stepped in to ease pressure on the hospital in York but Jonathan Coulter, chief executive at Harrogate and District NHS Foundation Trust, told a board meeting last month that the current system of accepting ambulances from York on an ad-hoc basis could risk patient safety.

He also said that staff have “normalised” a way of working that’s “very unusual”.

In response, a spokesperson for York and Scarborough Teaching Hospitals NHS Foundation Trust, which runs York Hospital, said “operational pressures are being felt across the NHS and our hospitals are no exception”.

They added: 

“To manage peaks in demand for services, it is common for emergency departments to seek short-term support from neighbouring hospitals and put in place short-term diverts in the interests of patient safety.  

“This helps reduce acute pressure on a particular hospital and reduces ambulance delays.”

At the meeting last month, Mr Coulter said the two NHS trusts were working together to try and find a solution that benefits both parties.

He added:

“We’re drafting a framework and are in discussion with colleagues in York about this. We’re having constant conversations with York and recognise the importance of working together. Our approach is to be really practical.”

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Harrogate hospital postpones 41 operations due to strikes

Harrogate District Hospital postponed 41 operations as a result of last week’s consultants and junior doctors strikes.

Members of the Hospital Consultants and Specialists Association and British Medical Association walked out from 7am on Monday, October 2, until 7am on Thursday, October 5.

Both junior doctors and consultants held the industrial action in a dispute over pay and conditions.

Harrogate and District NHS Foundation Trust confirmed 41 outpatient appointments were cancelled across a range of hospital services due to the walkout last week.

A spokesperson for the trust added:

“These have been re-arranged as a matter of priority. We are in discussions with six patients to confirm new dates for their operations.”

The trust confirmed that internal and bank staff were used to cover the strikes.

Bank staff are temporary workers who agree to work flexible shifts with a hospital trust. Some trusts keep a record of their own bank staff to call upon for shifts.

However, a trust spokesperson added that a total figure for the cost of staffing will not be available until the end of the month.

It comes as Harrogate hospital has been hit by numerous strike action this past year.

Between April 1 and August 31, junior doctors and consultants have staged multiple walkouts with some lasting as long as 48 hours.

The Stray Ferret reported last month that the trust spent £923,000 on staff cover for industrial action in the same time period.

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Harrogate doctor aims to ‘debunk the myth’ of penicillin allergy

A doctor at Harrogate District Hospital has set up a service to “debunk the myth” of penicillin allergy.

One in 10 people are currently diagnosed with a penicillin allergy but Dr Mike Wakefield, a respiratory consultant, said the true figure was thought to be closer to one in 100.

This meant people often received less effective antibiotics with greater side effects, he said.

Dr Wakefield said people diagnosed as penicillin allergic were more likely to die in the next year, require repeat prescriptions for antibiotics and contract superbugs. He said:

“Penicillin drugs which are used to kill bacteria are a vital part of the antimicrobial armoury.

“I’ve set up a service in the district to start challenging this by finding out more about why people have gained a label of penicillin allergic and when suitable given them a dose of penicillin under close observation.”

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Dr Wakefield said many people were told they were allergic to penicillin in childhood and never challenged this. Sometimes this was because they experienced side effects when taking penicillin but side effects are common with all drugs and don’t necessarily indicate allergic reactions.

He added GPs sometimes found it safer to prescribe alternatives. Also, many people grow out of childhood allergies.

Dr Wakefield said his service aimed to debunk the myth that penicillin allergies were widespread.

Since starting in Harrogate a year ago he has completed a pilot study of de-labelling patients branded penicillin allergic.

He has given supervised amoxicillin or flucloxacillin penicillin tablets to patients with frequent chest infections whose medical history indicated they might not have a real penicillin allergy.

If patients didn’t have a reaction, he said they could take penicillin-based antibiotics for future infections.

Dr Wakefield said a combination of supervised tests and clinical tests meant the likeliness of a true allergy could be understood.

Besides his ad hoc trials at the hospital, Dr Wakefield provides a penicillin service at the Duchy Hospital in Harrogate. People can either be referred by their GP or book appointments.

 

Harrogate hospital hoping to learn lessons from Lucy Letby murders

Senior figures at Harrogate District Hospital have said they want to learn lessons from the Lucy Letby murders to prevent similar crimes from happening in Harrogate.

Letby is a former neonatal nurse who murdered seven infants and attempted to murder six others at the Countess of Chester Hospital between 2015 and 2016. She was sentenced to a whole life order last month.

Harrogate and District NHS Foundation Trust’s board met on Wednesday at the Crowne Plaza in Harrogate where the Letby case was top of the agenda.

Emma Nunez, director of nursing and Jacqueline Andrews, executive medical director, gave a presentation that outlined what procedures the hospital has in place to spot patterns of behaviour and how it listens to concerns from staff.

Ms Nunez said:

“It’s difficult to stand here and say we are completely assured that it couldn’t happen here, there’s not an organisation in the country that could say that. However, through our good governance and staff engagement we are in a very good place.”

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She added that the trust has spent time looking at its quality governance, which has included establishing an end-of-life mortality committee to review deaths and prioritising its safeguarding committee. 

Ms Nunez said: 

“Mortality review is something nationally we’ve been asked to look at and how we monitor unexpected deaths.”

Ms Andrews reassured the board that the hospital has the resources to identify anomalies in mortality data which could lead them to investigate potential crimes.

She said: 

“We get a lot of mortality data, we have easily accessible data and we get a monthly alert on any mortality that’s an outlier. We do a deep dive into every one of them.”

Several doctors in Chester who worked alongside Letby said they tried to raise the alarm with hospital managers but were ignored.

Ms Nunez said the trust holds weekly talking sessions with staff where they can speak to managers.

She said she believes the trust fosters a culture where staff are able to voice concerns but she admitted there were still members of staff that were difficult to reach.

She said:

“We have quite a flat structure where it’s not unusual to see staff openly have concerns with executive team. At back of mind, what about the ones who are more difficult to reach? 

“That’s the question we need to ask ourselves, how do we reach those people?”

Harrogate hospital ‘crumbly concrete’ to cost £20m to eradicate

Health officials have estimated it will cost £20 million to eradicate “crumbly concrete” from Harrogate District Hospital.

RAAC, which stands for reinforced autoclaved aerated concrete, is a lightweight material that is less durable than traditional concrete and has a life expectancy of just 30 years before it runs the risk of collapse.

The first section of Harrogate District Hospital was built in 1975 during a period when RAAC was used in the construction of public buildings.

A report about the material at the Lancaster Park Road hospital was discussed at a meeting of Harrogate and District NHS Foundation Trust’s board yesterday at the Crown Plaza hotel.

The report said a full survey of the estate by engineers WSP found 2,500 RAAC panels. It added that remedial works have been completed on 12 “high-risk” panels with some theatres and corridors in the hospital made safe with props.

The report said there will be an annual survey of all RAAC panels and a roof with the concrete will be replaced.  

It said there may also be further propping of panels that are in danger of collapsing.

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To eradicate RAAC from the site, the trust has bid for £20m of funding to NHS England, which includes relocating demolishing and rebuilding a therapy services building.

Whilst there is RAAC present at Harrogate hospital, it is not as prevalent as in other hospitals in Yorkshire such as Airedale in the Bradford district. In May, the government announced it will be completely rebuilt due to RAAC.

Jonathan Coulter, chief executive at Harrogate and District NHS Foundation Trust’s, addressed RAAC in a statement.

He said: 

“There has been a flurry of activity in respect of the management of estate where there is RAAC present. This followed the concerns raised at the end of last month across the education system.

“To be fair, the NHS has been very aware of this issue and risks are being managed, but there is now greater concern and the threshold for risk is being challenged.

“As the board will be aware, we do have some RAAC across the HDH site that we survey regularly, manage, and have a plan for gradual replacement. As part of our capital plans, including our new theatre build, we are reviewing and assessing the potential to tackle this issue more quickly.”

Similarities seen in Yorkshire to how Lucy Letby whistleblowers were treated

Similarities to how whistleblowers were treated when raising concerns about convicted child killer Lucy Letby have been seen across Yorkshire hospitals, it has been claimed.

At a York and Scarborough Teaching Hospitals NHS Foundation Trust board of directors meeting on Wednesday, September 27, concerns were raised about how comfortable staff are at raising issues of colleagues’ clinical practice.

NHS staff can raise issues through ‘speak-up guardians’ like York hospital’s Stefanie Greenwood, who presented a report to the board and told directors there are lessons to be learned from how complaints about Letby were treated prior to her arrest in July 2018.

Ms Greenwood said:

“Although it’s a very extreme case, there are some lessons we can learn.”

She added that cases like Letby’s show “the price that we pay if we don’t listen to our staff” and that “silence ultimately kills patients.”

Ms Greenwood said: 

“Our staff currently do not feel safe to raise concerns.

“They fear reprisal and this can lead to unsafe patient care.”

She added: 

“I have seen similarities in how the Letby case was handled and staff being shut down and told they need factual evidence.”

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Letby was jailed in August for a whole life term for murdering seven babies and trying to kill another six at Countess of Chester Hospital between 2015 and 2016.

Dawn Parkes, interim chief nurse at York and Scarborough’s hospital trust, said “any hint” of something wrong regarding patient care should be “explored,” even if there is no hard evidence of wrongdoing.

Jenny McAleese, a non-executive director at the trust, said: 

“There’s not many concerns raised about safety and quality and I just wonder whether we just need to have a bit of a conversation about that and make sure people know that the freedom to speak guardian is there.”

She added: 

“People are happy to raise concerns about people working while sick but there’s a bit of a reluctance to raise concerns about people’s clinical practice.”

Letby, 33, is only the third woman to receive a whole life order and is Britain’s most prolific child killer.

Many of her surviving victims have been left with life-altering conditions.

Dr Stephen Brearey told BBC Radio 4 in August that when he raised links between Letby’s constant presence during a spike in infant deaths at Chester hospital he was “put into mediation by senior managers.”

He said:

“I was put into mediation twice, once on fairly minor grounds and secondly with Lucy Letby herself and it seems to be a way of delaying action and investigating those concerns.”

Dr Brearey added that it is “a way of turning the things back to the clinician and suggesting that they’ve done something wrong.”

He added:

“It’s almost like weaponising that process.”

There has been an increase in concerns being raised across York and Scarborough hospitals in the last three years but these were mostly about ‘behaviours and relationships’ or ‘bullying and harassment.’

Simon Morritt, chief executive of York Teaching Hospital NHS Foundation Trust, said: 

“How easy it is to raise concerns is really important to us.”