Harrogate District Hospital has received new equipment to improve lung cancer treatments.

Harrogate and District NHS Foundation Trust said the new equipment would allow staff to carry out endobronchial ultrasound scans (EBUS), which are used for diagnosing and staging lung cancer.

Patients currently have to travel to other hospitals for the scans.

The trust added the equipment can also be used to test for infections and chronic inflammatory diseases.

It added the procedure, which takes less than an hour, will improve patient care and waiting times.

Dr Khizer Khan, consultant in respiratory medicine at the trust, said:

“Previously patients would need to be referred to other NHS trusts for the EBUS procedure, leading to patients waiting during the referral process and inconvenient trips for patients between hospitals.

“However, with the ability to perform EBUS scans at Harrogate District Hospital, patients can receive more timely assessment and then treatment based on their current cancer diagnosis.”

A trust spokesperson told the Stray Ferret the equipment cost about £200,000.

The hospital’s lung and cancer service has also introduced a new treatment for lung cancer patients who develop liquid between their lungs and chest cavity.

The trust said the treatment, known as indwelling pleural catheters, means once patients have had the specially-designed drainage tubes fitted they no longer require visits to the hospital to drain the fluid. Instead, nurses can drain the fluid at the patient’s home.

Dr Khan added:

“I have already performed several procedures at Harrogate District Hospital which have been a great success for both the patients and our team.

“The indwelling pleural catheter serves as a bridge between pain and comfort, empowering patients to navigate their days with dignity and grace.”

Pictured are (left to right) Dr Sana Ahmad (respiratory registrar), Dr Khizer Khan (respiratory consultant), Benice Mpholle (endoscopy nurse), Howard Richardson (endoscopy nurse), Michael Wakefield (respiratory sonsultant), Brian Drummond (endoscopy nurse).

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A dental clinic in Boston Spa has announced it will take on NHS patients affected by the reduction in NHS service by Pannal Dental Clinic (PDC). 

As the Stray Ferret reported in November, PDC was forced to reduce its NHS contract after being hit with a demand for tens of thousands of pounds from the Integrated Care Board (ICB) that gave it its contract. 

Consequently, it is focusing on prioritising children, leaving its adult patients to choose between staying on with a private dental plan or finding a place on an alternative dentist’s NHS list.

Having recently read the Stray Ferret’s story, 210 Dental Clinic on Boston Spa’s High Street – more than 10 miles away – has said it is willing to take on PDC’s patients. 

William Hamer, practice manager at 210 Dental Clinic, said: 

“Harrogate had a lot of problems recently with practices closing their lists, and NHS patients finding it difficult to be seen.

“Fortunately, we recently had a fourth surgery installed. Our dentist can take care of the more complex procedures, such as dentures, crowns and bridge work, but our dental therapists are fully trained to do examinations, x-rays and even fillings.

“If PDC’s patients are looking to be seen on the NHS, we can offer them that.”

But Tom Gordon, the Liberal Democrats’ parliamentary candidate for Harrogate and Knaresborough, said that people in Pannal “should not be forced to wait five months to be offered an NHS place 10 miles away”. He added:

“It is clear that our NHS dental system is completely broken and it is leading to unacceptable situations such as this.

“With NHS appointments scarce at best and in some places not existing at all, people are being forced to spend hundreds, if not thousands of pounds on private dental care with some even resorting to their own at-home DIY dentistry.”

He was referring to a YouGov survey from March 2023 which found that one in 10 (10%) people had attempted their own dental work. The poll also found that one in five people in the UK (22%) are currently not registered with a dentist, and of these, 37% said this was because they couldn’t find an NHS dentist.

The British Dental Association (BDA) has said that NHS dentistry is facing a “genuine crisis” of access. 

But Andrew Jones MP told the Stray Ferret:

“As I understand it, the delay in securing additional NHS places has been due to protracted negotiations with Pannal Dental Clinic who, according to the Integrated Care Board (ICB), are only reducing their NHS contract temporarily.  It took the clinic and the ICB some time to confirm that arrangement.

“In a letter to me the ICB have said: ‘This temporary reduction in activity has been implemented due to changes to their workforce meaning they are currently unable to meet the previous activity requirements’.

“I hope that the workforce issues at Pannal Dental Clinic, which the ICB tell me are the problem the clinic has identified to them, are resolved soon so that they can resume their full contract.

“It would appear that there is still funding released by Pannal to be reallocated and I have asked the ICB to do their utmost to keep that funding as local as is possible.”

Mr Jones supported the introduction of the government’s dental recovery plan, which was launched in February. Under the plan, dentists are to be offered a bonus to take on more NHS patients, which ministers say will create more than 2.5 million new appointments over the next year.

Dentists will also be offered ‘golden hello’ cash incentives to work in under-served areas, potentially allowing around 1 million new patients access to NHS dental treatment.

But Mr Gordon said:

“For years there have been hundreds of millions of pounds of underspend on NHS dentistry and the Liberal Democrats have back the BDA’s calls to reform the contracts to get this money spent on fixing people’s dental problems.

“Yet this Conservative Government has done next to nothing to tackle this crisis.

He added:

“It is high time that the NHS dental system was reformed and plans brought forward to end this mess, so no matter where you live you know you can get the NHS dental care you need in an emergency.”

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Harrogate District Hospital could face a further six months of disruption after junior doctors voted to extend their mandate for strike action.

It’s been over a year since junior doctors began striking over pay and this week 98% of British Medical Association union members backed further walkouts on a turnout of 62%.

Most recently, junior doctors at the Lancaster Park Road hospital staged two separate walk-outs between December 20-23 and January 3-9.

The strikes have had a “draining impact”, according to the boss of Harrogate & District NHS Foundation Trust.

Junior doctors are qualified doctors in clinical training and they make up nearly half of the medical workforce in England.

The BMA says while workload and waiting lists are at record highs, pay has effectively been cut by more than a quarter since 2008.

The union is asking the government for a 35% pay rise, but health ministers have described the demands as unreasonable.

A spokesperson for Harrogate and District NHS Foundation Trust said the hospital hopes a deal can be reached before future strikes take place.

They said:

“Whilst we respect the decision made by BMA junior doctors to extend their mandate for industrial action, we hope that the BMA and government can have effective discussions which will lead to a solution before further strikes are undertaken.

“Should further industrial action take place we will continue to manage the disruption to ensure our patients are safe during the strike, any impact on patient care is kept to a minimum and emergency services continue to operate as normal.

“We value our staff and know that junior doctors do not want to be striking. We hope a breakthrough can be made soon so that we can continue to focus on delivering high quality care to all those who need it.”

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Two Harrogate GP surgeries are set to merge towards the end of this year.

East Parade Surgery and Park Parade Surgery, which are both located on the same floor of the Mowbray Square Medical Centre on Myrtle Square, announced the move today.

The practices said in a statement the surgeries already “work closely together and share several teams and services” .

It added the partners Emma Keating and Sarah Wilkinson felt a single, larger practice will allow them to “pool the skills of team members to create an organisation equipped to survive and thrive in the NHS of the future”.

The statement said:

“We believe in continuity of care and the people you already know will be part of the new surgery. There will also be the choice for you to see clinicians from across a larger team.”

The statement said the merger, which is being overseen by the Humber and North Yorkshire Integrated Care Board, will take place in early October, adding both sites will “work hard” to ensure a smooth transition for patients.

Patients already registered will be automatically transferred to the new surgery, which does not yet have a name.

The statement said people can contact the medical centre to express their views, as well as to submit ideas for a new surgery name.

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The boss of Harrogate District Hospital says improving its record in delivering timely cancer treatment is being made more difficult due to doctors going on strike.

Jonathan Coulter, chief executive of Harrogate & District NHS Foundation Trust, made the comments in papers published ahead of the organisation’s board meeting in Harrogate yesterday.

Mr Coulter admitted the hospital was facing challenges in delivering the “standard that we would want to” but added that several waves of industrial action have taken their toll.

Across England and Wales more than one million treatments and appointments have been cancelled due to the strikes with waits for cancer treatment being particularly affected.

NHS England says a patient should start treatment within 31 days of an urgent cancer diagnosis and referral by a GP.

Statistics published by the hospital reveal 9 in 10 patients are receiving treatment within this target.

However, after 62 days since a referral, only 7 in 10 patients have begun treatment.

Mr Coulter added: 

“It is fair to say that this is the area that has been most significantly impacted upon by the industrial action, with clinics cancelled, but if we assume that there will be no further service interruptions due to strikes, then we have plans in place to deliver the overall Faster Diagnosis Standard expected by the end of the year.”

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Both consultants and junior doctors took part in industrial action at the hospital in the first week of October.

The BBC reported this week that a fresh pay offer has been made to NHS consultants which could end future strike action.

The government is also in negotiation with junior doctors although a deal has not yet been agreed.

Mr Coulter added: 

“We need to always remember the impact that this industrial action is having and the cost to patients who have services disrupted and delayed, the actual financial cost of cover, and the more significant opportunity cost, as management time is necessarily taken up with planning and managing these periods of strike action safely. We know in particular that this has had an impact on our cancer pathways as clinics have been cancelled.

“And at a time when the NHS is being criticised in some quarters for poor productivity, we know that staff morale and goodwill – so important in the delivery of safe, productive services – is not helped by this ongoing dispute.”

A Harrogate dental clinic will no longer provide a full NHS service next year because it says it cannot afford to. 

Pannal Dental Clinic (PDC) sent letters at the weekend to its patients to let them know of the new arrangements.

The letter, which has been seen by the Stray Ferret, said: 

“As of the 1st January 2024, our team will cease to provide NHS care for adults. Instead, we will be able to provide your dental care on a private basis and to aid this transition we have introduced a patient membership plan.” 

The change came as a shock to some patients, including Pannal resident Petra Turner.

She told the Stray Ferret: 

“A number of Pannal and Burn Bridge residents are now finding that they have to join the PDC dental plan or stay on as a pay-as-you-go (a lot of money) patient in order to stay on their list.” 

She added: 

“We (a family of four) have been with this practice for 22 years. If the three adults in our family were to join the PDC basic plan, we would have to pay £750 a year. This would include two dental check-ups and two hygienist appointments per person. A very nice hourly rate.” 

But Dr Greg Cadman, owner and principal dentist at PDC, said he had no choice but to reduce the NHS contract. 

Under a system introduced in 2006, any dental practice working to an NHS contract must fulfil a target of units of dental activity (UDAs) set by the Integrated Care Board (ICB) that gave it the contract. 

A check-up is worth one UDA, but a filling is worth three. Confusingly, multiple fillings in one visit still count as three UDAs.

Earlier this year, Parliament’s Health and Social Care Committee called the UDA system “not fit for purpose”. 

Pannal Dental Clinic has failed to meet its targets in three of the last four years, and missing them carries a penalty known as a “clawback”, where the ICB can claim back the value of the underachieved units.

As a result, the practice had to pay back a large sum of money. 

Dr Cadman said: 

“We are not terminating our NHS contract – we are reducing it and prioritising children.

“We lost a couple of associates due to them wanting to work privately, and another went on maternity leave. With staffing levels like that, it became impossible to hit the target.

“There’s no clawback if you fulfil 90% of your UDAs, but we hit 89.7% – just 0.3% off the target – so we were hit with a full clawback of tens of thousands of pounds that had to be paid within just three months.”

He said the problem had been exacerbated by the recruitment crisis in the NHS, which had grown more acute since Brexit and the Covid pandemic. He said: 

“There always used to be dentists who would take on NHS work, but now many are finding it too difficult under the current system. We’ve advertised for new NHS dentists in numerous places for six months – without a single applicant. Even dental nurses are hard to find.

“There’s definitely still a place for the NHS – it’s really important, and I don’t want to see it go. But for practices like ours, working within it is very difficult.”

The reduction in PDC’s NHS contract is symptomatic of a national trend. The British Dental Association has said that NHS dentistry is facing a “genuine crisis” of access.

A YouGov survey in March 2023 found that one in five people in the UK (22%) are currently not registered with a dentist, and of these, 37% said this was because they couldn’t find an NHS dentist.

One in 10 (10%) even admitted to attempting their own dental work.

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NHS dental patients at Chatsworth House Dental Clinic, in Harrogate, will be offered treatment at alternative NHS practices next month.

Chatsworth House, on King’s Road, announced in September it would stop providing NHS treatments from December 1.

The move heightened concerns about the lack of access to NHS dentistry in the Harrogate district.

It prompted Andrew Jones, the Conservative MP for Harrogate and Knaresborough, to seek assurances from the Integrated Care Board for Humber and North Yorkshire that local NHS provision would be expanded.

Mr Jones said today he had been told any patient on Chatsworth House’s roll in the last two years will be sent a letter by the NHS next month explaining where the new provision will be available.

Subject to the terms and conditions of their contract, any former NHS patient who has signed up for private services with Chatsworth House can apply to a new provider.

Mr Jones said:

“This is good news for NHS patients at Chatsworth House.  It was important that the cash provided for NHS dental activity at Chatsworth House remained invested in Harrogate NHS dentistry.  I am grateful to the ICB for ensuring this is the case.”

The ICB letter to Mr Jones said:

Mr Jones added he had “longer term aspirations for dentistry in our area:, adding:

“I want to see a centre of dental excellence for North Yorkshire based in Harrogate. This will train the next generation of NHS dentists and could help provide more capacity locally.  I have also met two dentists locally who are looking to expand their practices and put them in touch with people in the NHS who can help with that.  These discussions look very positive.

A review of NHS dentistry in August 2021 also found that there was just one NHS dentist practice per 10,000 people in the Harrogate district.

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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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North Yorkshire Council looks set to bid for up to £1.7 million worth of funding to help ease pressure on hospital emergency departments.

The Department of Health and Social Care has invited local authorities to apply for grants to help with discharges in social care, which in turn will support accident and emergency units.

Ministers have allocated North Yorkshire as one of the authority areas which has the “greatest health and care challenges”.

The government has given the council an indicative funding amount of £1.1 million, but has encouraged it to apply for up to £1.7 million.

A report by Abigail Barron, assistant director for prevention and service development at the council, has proposed a number of measures as part of the council’s bid.

Among them include employing additional agency social workers to speed up discharge allocations, establishing winter grants for the voluntary sector to help with prevention and developing additional support for unpaid carers.

Ms Barron said the measures would help to “avoid hospital admissions and expedite discharge and flow”.

She added:

“The schemes will also assist North Yorkshire Council’s strategic objective of both supporting hospital discharge and reducing reliance on short stay residential beds.”

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The move comes after Harrogate District Hospital managers raised concern that patients were staying in hospital longer than they should because of a lack of private care services.

Last year, Jonathan Coulter, chief executive at Harrogate and District NHS Foundation Trust, said the issue had a knock on effect on emergency departments and was the “biggest issue” that the trust faced.

In September 2022, the trust also outlined plans to launch its own home care service in a bid to free up hospital beds.

At the time, the move was met with some concern by councillors who said it could “distort the market”.