Harrogate hospital says strikes ‘significantly impacting’ cancer treatmentThe 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.”
Read more:
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.”
Pannal dental practice stops treating adults on NHSA 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.
Read more:
Chatsworth House dental patients in Harrogate to be offered alternative NHS provisionNHS 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.”
Mr Jones said more than 50 Chatsworth House patients had contacted him.
The ICB letter to Mr Jones said:
“We have written to eligible dental providers in Harrogate to invite them to submit an expression of interest in taking on more dental activity. This EOI went out week commencing 30 October and providers have been given two weeks in which to respond.
“Once EOIs are received, officers at the ICB will then consider all EOIs in order to allocate the dental activity. As soon as new providers are confirmed, the ICB will ensure that patients from Chatsworth House are written to, explaining where they may be able to find an alternative dentist.”
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.
Read more:
York hospital defends sending ambulances to HarrogateYork 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.”
Read more:
Council to bid for £1.7m emergency funding for hospital dischargesNorth 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.”
Read more:
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”.
Health chief pledges to help patients at Harrogate NHS dentistNHS dentistry provision was discussed at a meeting yesterday between Andrew Jones, the MP for Harrogate and Knaresborough, and Stephen Eames, the chief executive of the Humber and North Yorkshire Integrated Care Board.
The issue was highlighted recently by the announcement that Chatsworth House dental practice on King’s Road in Harrogate was closing to NHS patients from December 1.
The meeting was a follow-up from a briefing this month which the ICB – a collaboration of health and care organisations tasked with improving the health and wellbeing of people in the region – arranged for all Humber and North Yorkshire MPs.
Mr Jones said:
“We have a short-term issue – one that I raised at Prime Minister’s Questions – about what happens when a practice suddenly closes to NHS patients as has happened here. We also have a medium-term issue about increasing NHS dentistry capacity. Mr Eames and I discussed both these issues.”
Chatsworth House Dental Clinic
The ICB told Mr Jones it is planning to redistribute the funding given to Chatsworth House to other local practices so that they can take on more patients. Patients affected will be contacted directly by the ICB to explain where their new practice will be.
According to a government briefing published in April 2023, total funding for NHS dental services in England fell by 8% in real terms between 2010 and 2022.
Read more:
The crisis in NHS dental provision was highlighted by a YouGov poll in March. The survey found that more than a quarter of the UK population (27%) have not seen a dentist within the last two years, and one in five people (22%) are currently not even registered with a dentist.
Of those, 37% said it was because they couldn’t find an NHS dentist, and 23% said it was because they couldn’t afford to pay for treatment. One in 10 admitted to attempting their own dental work.
To help address the problem, the ICB is looking to increase NHS dental capacity locally through the rapid launch ‘Centres of Dental Development’, which are intended to support, develop and retain the dental workforce across the Humber and North Yorkshire.
Mr Jones said:
“It is good that the ICB are looking at the long-term sustainability of our dental service. This is a positive and constructive approach and I have asked that Harrogate, which is the largest town in North Yorkshire, will be host to one of these new centres.
“Such a facility would place front and centre significant dental provision for our area. It could educate a new generation of local dentists. To have such a centre in Harrogate would be a huge boon to our area.
“I look forward to receiving more details from the ICB and feel hopeful that my request for a Centre of Dental Development in Harrogate will be successful.”
Andrew Jones MP urges Prime Minister to ease ‘strain’ on access to Harrogate NHS dentistsHarrogate and Knaresborough Conservative MP Andrew Jones today urged the Prime Minister to tackle the “immediate strain” facing local people trying to access NHS dentists.
Concerns about a shortage of NHS dentists in Harrogate were heightened last week when Chatsworth House Dental Clinic, on King’s Road, said it will stop treating NHS patients at the end of the year.
Speaking at Prime Minister’s Questions today, Mr Jones said he and fellow North Yorkshire MPs met with the local integrated care board last week to discuss ways of improving dentistry provision. He added:
“But when surgeries suddenly close to NHS patients without notice as one in Harrogate did very recently, an immediate strain is put on local provision.
“Will the Prime Minister look at what can be done in these circumstances to ensure that no one is left without access to an NHS dentist?”
Mr Sunak pledged to “look into this issue” and said Mr Jones would be “reassured” to know the government was investing £3 billion a year into dentistry. He added there were no geographical restrictions on which dentists people could attend.
‘Sitting on the sidelines’
Tom Gordon with Daisy Cooper, the Liberal Democrats’ health spokesperson.
The man who hopes to succeed Mr Jones as Harrogate and Knaresborough MP at the next election accused his rival of “sitting on the sidelines” over dentistry.
Tom Gordon, the Liberal Democrat parliamentary candidate, said he was “pleased that after 13 years Andrew Jones has finally bowed to pressure and asked a question in Parliament about the dentist crisis affecting local residents”, adding:
“In the last six months, the Lib Dems have been increasing the pressure on him to do this. We have set up a dentists survey, arranged a meeting with the Lib Dem shadow health minister and made sure that questions were asked in Parliament about this issue.
“We’ve heard awful stories about how local people have been putting up with pain as they can’t afford to see a dentist. It shouldn’t have required a concerted campaign to make our MP act.”
“We’re determined to keep on fighting for the cash that will re-establish NHS dentistry in our area. We hope Andrew Jones will join us in this fight rather than sitting on the sidelines as he has done over this and many other issues for the last 13 years.”
Following his meeting with Humber and North Yorkshire Integrated Care Board last week, Mr Jones said:
“Dental services have been recovering but there is much more progress to be made.
“It is important that action is taken swiftly to expand the NHS dental provision in our area.”
Read more:
Harrogate hospital awards consultants £1.2m to embed culture of ‘continuous improvement’Harrogate District Hospital is spending nearly £1.2m on hiring management consultants to develop a culture of continuous improvement, the Stray Ferret can reveal.
Harrogate and District NHS Foundation Trust (HDFT) signed a contract with KPMG and Catalysis in March, which will run for 18 months to September 2024.
KPMG is one of the world’s largest multinational professional services companies, and Catalysis is a Wisconsin-based not-for-profit organisation dedicated to helping healthcare bodies become more efficient.
The continuous improvement programme, called HDFT Impact, will ultimately involve all 5,000-plus employees, who will be encouraged to share their knowledge with each other and come up with ways to improve the way the trust delivers its services.
In a statement sent to the Stray Ferret, a spokesperson said:
“It is our aim to embed improvement at the centre of our culture and operating model so we can provide the best quality, safest health and care services for our patients, children and the community; and make HDFT the best place to work for our colleagues.”
They added:
“There is no doubt that a steady stream of improvements, both big and small, can have transformational results.”
In recent years, KPMG and Catalysis have together worked with 16 NHS trusts, including Western Sussex, which became the first non-specialist trust to be rated outstanding in all areas by the Care Quality Commission.
In other cases, one trust saved £800,000 in theatre efficiencies, one increased surgeries per list by 25%, and another reduced falls among patients by 60%.
The spokesperson said:
“Continuous improvement is not a new concept at HDFT. It has been integral in helping us to develop our services and bring improvements for patients and colleagues for a long time – we have been using a lean quality improvement approach for over 10 years.
“We know this approach works and we’ve seen the improvements it can bring for patients and colleagues.”
Read more:
The HDFT Impact programme is being funded from the trust’s budget to procure and implement a new electronic patient record system.
The spokesperson said:
“Our EPR project is not just about providing an electronic system, but is an improvement programme enabled by technology to give our staff the opportunity to improve across the whole organisation.”
In May, it was reported that management consultants were being paid up to £3,000 a day for work within NHS England. At the time, Onay Kasab, national lead officer of trade union Unite, said the health service was being “plundered by private sector profiteers”. He added:
“The money would be much better spent providing a proper pay rise for NHS staff to end the recruitment and retention crisis that is crippling health services.”
HDFT’s deal with KPMG and Catalysis is costing the trust about £2,200 per day for the duration of the 18-month contract.
Asked if there had been any opposition or resistance from hospital staff to the hiring of external consultants, the spokesperson said:
“As an organisation, the majority of our colleagues are receptive to continuous improvement.
“Cultural change can be challenging, and a small number of people may be sceptical, but we believe that developing our continuous improvement programme is vital in our pursuit of excellence so that we can raise quality, reduce costs, explore better ways of delivering our services, and provide the best possible healthcare for those who need it.
“We hope that as the programme progresses and staff engage in it, all of our staff will recognise the huge benefits.”
Calls for urgent action to stop North Yorkshire children vapingCalls have been made for urgent action to tackle children vaping across North Yorkshire amid an “explosion” in young people using e-cigarettes.
A meeting of North Yorkshire Council’s children and young people’s scrutiny committee heard the authority’s annual health and wellbeing survey concluded more than one in three of children aged 13 to 15 years old had at least tried vaping, while 9% said they used them regularly.
Smoking of traditional cigarettes was continuing to decrease and the use of illegal drugs remained low, the meeting was told, but some children were starting to vape while still at primary school.
The study found some 5% of 10 and 11-year-olds pupils responded that they had at least tried vaping.
However, councillors were warned the vaping statistics in its Growing Up In North Yorkshire study were “woefully out” and the actual prevalence of vaping was likely to be much higher.
Earlier this year Dr Mike McKean, of the Royal College of Paediatricians and Child Health, said vaping was becoming “an epidemic” among teenagers.
He said if the growth of youngsters vaping continued at the same rate, almost all children would vape within five years.
Dr Tom Cavell-Taylor, who is a governor at Ripon Grammar School, told the scrutiny meeting:
“I don’t think young people appreciate the dangers of vaping.
“Vaping was seen as a better alternative to smoking, but there is a bit of a health time bomb going on with vaping and I don’t think that message is fully appreciated with young people.”
Cllr Kirsty Poskitt, who is also a youth worker, added it was “not unusual for year five and six pupils to be vaping”.
She said:
“What I’m really concerned with is how fast the public health is getting out. I have conversations daily with young people that vape that have no clue that it is in any way dangerous.
“The parents see it as a much better, they taste and smell nice, they’re trendy, you’re not going to have that first hacking experience of cigarettes.
“It’s a huge explosion and it’s one of my biggest concerns with young people.”
Read more:
The meeting heard councillors call for the government to step up campaigns to raise awareness of the dangers of vaping in the way that it has highlighted the risks of smoking tobacco and drinking alcohol or ban the sale of single-use vapes.
Councillors said by looking at the images in the windows of vaping shops alone, it was obvious children were being targeted.
The authority’s director of children and young people’s services, Stuart Carlton, said while he appreciated the immediate need to raise of the risks of vaping, it would be worse to launch a campaign that wasn’t accurate.
He said one of the issues with tackling vaping was that “the market moves really quickly”, so it was important to get messages precise.
Mr Carlton said:
“I would just ban them. I think they should only be available on prescription as part of a smoking reduction programme to adults only. That’s how you get them out of the system.
“Some of the things that are giving us the most concern aren’t the ones sold in shops, it’s the illegal market. These are black market vapes with cannabinoid additions which are causing horrendous incidents to children who experiment. You can do something about vaping, but then miss the thing that’s doing to most damage.”
The scrutiny committee was told public health officials were teaming up with a range of bodies, including the NHS and Trading Standards, to tackle the issue in a coordinated way.
Health Secretary called upon to keep Ripon dental practice openRipon City Council is seeking government intervention to stop the closure of Bupa’s Finkle Street dental practice.
At last night’s full council meeting, councillors voted unanimously to write to Health Secretary Steve Barclay amid concerns the planned closure of the practice will further reduce access to treatment for NHS patients in the city.
Bupa’s Finkle Street branch which has NHS and private patients on its books, plans to shut its doors on June 30, with the national company citing a lack of dentists to provide care.
Its Clock Tower practice in North Parade is unaffected, as are Harrogate’s Raglan Suite and Bupa Dental Care in East Parade – but none of these is accepting new adult NHS patients.
Cllr Peter Horton said:
“There are masses of people in Ripon in need of NHS dental care, but they now have to travel to places as far away as Guiseley and York to receive treatment from Bupa.
“This is completely unacceptable and we need to state in the strongest terms that we want the Finkle Street practice to stay open.”
Cllr Pauline McHardy said:
“No practices in Ripon are taking NHS patients and the situation is getting worse with more dentists going private.
“The government has overall responsibility for NHS dental services and they need to sort this out.”
Read more:
In addition to writing to the Secretary of State for Health, the council is also calling on Ripon Conservative MP Julian Smith and North Yorkshire Council’s Skipton and Ripon area constituency committee to support its bid to keep the Finkle Street branch open.
Independent city council leader Andrew Williams said:
“This is a very serious issue, not just here but across the country with an estimated 11 million people having no dentist.”
The Finkle Street branch is one of 85 across the country being closed, sold or merged over the coming months. As well as problems with recruiting, Bupa said rising costs influenced its decision.
Last month, at the time of announcing the closures Bupa Dental Care general manager Mark Allen said:
“As a leading dental provider in the UK, our priority must be to enable patients to receive the care they need.
“For the majority of affected practices, this decision will allow commissioners to procure local providers for the NHS contract, tailoring services and investment to the needs of the local community, thereby providing a better opportunity for patients to continue access to NHS dental services.”
Bupa said it will hand back its dental contract in Ripon to the NHS, allowing commissioners to find a new provider for NHS dental services.