A Guardian investigation has revealed significant shortcomings at the three hospital trusts used by constituents of Theresa May in Maidenhead and Jeremy Hunt in South West Surrey. The trusts are the Royal Berkshire; the Royal Surrey County hospital in Guildford; and Frimley Health.
Royal Surrey County hospital NHS foundation trust
Hospitals providing cancer care are meant to treat 85% of patients within 62 days of referral by their GP. Royal Surrey has failed to meet this target for the last 21 months in a row, and in 2016 was the 19th worst out of 141 care providers in England on this measure, treating just 75.2% of patients on time. On average, 17 patients a month have to wait longer than that for potentially life-saving cancer treatment.
Royal Surrey was the 15th worst out of 160 providers last year on the target to treat 96% of all patients diagnosed with cancer within a month.
It failed to achieve the target of treating 95% of A&E patients within four hours throughout 2016-17, except in March this year. In all, 8,344 patients had to wait longer than that.
Plans to refurbish its urology centre had to be put on hold due to lack of cash, although they are now back on track.
On planned operations, Royal Surrey has been breaching the 18-week target from GP referral to treatment since May 2016 and has among the worst waiting times for specific illnesses in England. In the year to April 2017, Royal Surrey was the sixth worst performer for rheumatology, 14th worst for treating prostate conditions – for which it hasn’t met the target for more than three years – 21st worst for cataract surgery and other eye conditions and 26th worst for stomach disorders, NHS data shows.
It cancelled more than 1,400 operations last year, including 321 in trauma and orthopaedics, 128 gynaecological procedures and 261 general surgical operations.
The hospital “temporarily” stopped providing acute stroke services in December, sending patients to Frimley Park hospital 15 miles away. The arrangement looks set to become permanent, despite public opposition and even Hunt showing concern about the ability of the local ambulance trust to get patients to Frimley Park within the crucial two-hour window.
In the 14 months between January 2016 and February 2017 at Royal Surrey, one patient died and 24 others suffered severe harm and in all 52 serious incidents were investigated.
A Royal Surrey spokesman said the NHS nationally was facing “unprecedented demand and pressure”, and it had increased the number of nurses it employed by 13%. It declined to set out what the impact of so many delays in providing timely care would be on patients’ mental or physical health.
Royal Berkshire NHS foundation trust
In November 2016, Royal Berkshire hospital put an eight-bed Portakabin outside its A&E department to speed up the handover of patients from ambulance crews to hospital staff. All patients whose lives are not in immediate danger are checked in at the Portakabin, where assessment and treatment is started.
“For us, it’s much better – we used to queue for ages in corridors,” said a paramedic with the South Central ambulance service who regularly delivers patients to the RBH, and who did not want to be named. However, patients are not seen any quicker and “we still get people waiting on trolleys in the corridor who have been handed over to hospital staff but are waiting to be seen by a doctor”, the paramedic said.
Understaffing is so acute that the hospital had to use locum or agency doctors to cover 6,059 shifts during 2016 and stand-in nurses 19,088 times. They were mostly in acute medicine, on older people’s wards and in paediatrics. Royal Berkshire wants to hire 100 nurses from the Philippines.
Royal Berkshire cancelled 220 operations in 2016 and 67 in the first three months of 2017. It does well on many planned operations but is the 11th worst trust for plastic surgery waits. It has not met the target to treat 92% of patients within 18 weeks since September 2015.
It breached the four-hour A&E target in all 12 months of 2016-17. A total of 9,612 patients had to wait longer than that.
Lapses in patient safety led to 17 patients dying or suffering major or severe harm during 2016, and 60 different serious incident inquiries were undertaken.
A recent Facebook post by Rebekah Hodgson, about how understaffing at the Royal Berkshire had contributed to her mother receiving poor care, has been shared widely on social media.
“That last night no one was free to help my mum go to the toilet,” it read. “The staff were appalled with how long she had to wait for personal care and greatly distressed to have caused her and us such upset, but they had to firefight.”
Frimley Health NHS foundation trust
The trust meets key targets for cancer treatment within 14, 31 and 62 days. But it failed to meet the target for seven different types of cancer treatment within 62 days of urgent GP referral in January, February and March 2017. They included lung, gynaecological and blood cancers. A spokesman said the seven were the areas of cancer care “where we need to make the biggest improvements”.
Understaffing is particularly acute at Wexham Park, which some Maidenhead residents use: it is short of 200 nurses. The trust hopes to recruit 50 nurses from the Philippines, but says: “Immigration rules have caused big delays, which has meant that the vacancy rate has remained higher than planned.”
It has had to increase some pay rates to try to tackle shortages of A&E doctors at both Wexham Park and Frimley Park hospitals. The trust used locums and agency staff to cover 41,055 shifts in 2016. It refused to disclose how much this cost.
A total of 20,049 patients had to wait more than four hours for A&E treatment in 2016-17. The trust met the 95% target in only two of the 12 months.
Acute stroke services have recently been taken away from Wexham Park hospital. Patients now have to travel 18 miles to High Wycombe hospital in Buckinghamshire.
Although the trust does well on many treatment targets, it has been struggling to treat its trauma and orthopaedic patients within the 18-week window, with just 86% of patients in 2016-17 seen in that time.
Twelve patients died and another 16 suffered severe harm as a result of lapses in safety standards and a total of 66 serious incidents were investigated.
Frimley Health said: “In relation to staff levels, we do have a high vacancy rate, especially at Wexham Park. This hospital is just outside the M25 so has to compete with London hospitals where staff get paid more via London weighting. We have made big inroads into vacancies … We know that we still have more work to do.”
