Appointment delays 'a risk' for hospital patients

Patients at Derby and Burton hospitals are being put at risk by almost 100,000 overdue follow-up appointments, local NHS leaders have said.

According to recent board papers, University Hospitals of Derby and Burton (UHDB) NHS Foundation Trust was grappling with a "concerning" number of 98,722 overdue appointments at the end of October, compared to a target of 85,474 - described as "off-plan and worse than last year".

A meeting of the NHS trust's leaders on Tuesday heard the delays were a "risk to patient care".

In a statement Dr Gis Robinson, executive chief medical officer, acknowledged that waiting longer for follow-up appointments was "worrying and frustrating" for patients' ongoing care.

The biggest departments facing backlogs are ophthalmology, with almost 20,000 delayed appointments, and cardiology, with 12,000.

"While patients waiting for these appointments have already been seen by our services, we are clinically reviewing our waiting lists to make sure those with the greatest need are prioritised for their follow-up," Robinson said.

"We are also creating more appointments, making better use of existing clinics and carrying out targeted work in the areas where we have the longest waits.

"This work is already helping thousands of patients receive their follow-up care, but we know we need to go further and reducing these waits remains an important priority for us."

It comes as the trust also faces deteriorating performances on waiting times, ambulance handover and corridor care pressures, ahead of the onset of the peak period for winter pressures.

The proportion of emergency department patients facing waits of over 12 hours has almost doubled in two months, jumping from 10% in August to just under 18% in October.

Those waiting to be transferred from an ambulance into hospital for over 45 minutes almost quadrupled, rising from about 7% in August to almost 32% in October.

Meanwhile A&E attendances have seen a 4% increase compared to this time last year.

At the meeting on Tuesday, leaders particularly stressed the need to tackle the number of patients being treated in corridors ahead of winter pressures setting in.

Figures from the trust show almost 40 patients were treated in emergency department corridors in September, despite an ambition expressed by hospital leaders at a meeting that month to "eliminate corridor care" except for in "exceptional" circumstances.

The trust's chief executive Stephen Posey said reducing corridor care was "integral" to winter planning preparations and a "huge focus" for staff.

"While these spaces are safe, we recognise the impact this can have on privacy, dignity and patient experience and remain committed to reducing their use wherever possible," he said.

"Our fundamental priority is of course safe, quality care."

He also apologised for the "very long waits" currently facing patients.

"We're very clear that we need to do better this winter," he said.

The trust said most additional care spaces that met the definition of "corridor care" were "extra beds within ward areas".

The trust's winter plan includes expanding on the Same Day Emergency Care policy, which aims to reduce overnight admittance by assessing, treating and discharging patients on the same day.

At Queen's Hospital Burton, extended Emergency Medicine Ambulatory Care similarly aims to assess and treat appropriate patients without unnecessary admissions.

A UHDB spokesperson said: "We know our urgent and emergency care performance is not where we want it to be and that some patients are waiting too long when they come to A&E.

"This is particularly important as we head into a busy winter period, so we are expanding services that allow more patients to be assessed, treated and go home on the same day, supporting patients to move through and out of hospital as soon as they are well enough, and drawing on national best practice to improve the way our urgent and emergency care services work.

"We are also working closely with GPs, community services, ambulance colleagues and other partners across Derbyshire and Staffordshire to help people get the right care in the right place, while making sure hospital services are there for those who need them most."

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