Norfolk and Waveney health bosses told to make improvements

Norfolk and Waveney health bosses have been given a warning to resolve key failings swiftly, in particular at Norfolk's biggest hospital.

The strategic health authority has told NHS Norfolk and Waveney that it has failed to achieve a number of central measures and needs to do more to tackle problems such as ambulances queuing outside hospitals, inconsistent A&E waiting times, health care-acquired infections (HCAIs) such as C.Difficile and MRSA and the waiting times that patients are waiting for treatment, particularly for procedures such as hip and knee replacements.

The call for improvements comes as it emerges NHS Norfolk and Waveney and the Norfolk and Norwich University Hospital NHS Foundation Trust have been unable to agree a contract for 2012-13 in a dispute over waiting times for orthopaedic surgery and plans to impose penalties for failing to improve ambulance turnaround times. The two issues were highlighted as areas of concern in NHS Norfolk and Waveney's annual performance review by its boss, the strategic health authority NHS Midlands and East. In a letter summing up the primary care trust cluster's performance in 2011-12, NHS Midlands and East chairman Sarah Boulton told NHS Norfolk and Waveney that key issues raised the year before and at regular performance reviews during the year had not been sufficiently addressed.

She wrote: 'We note that delivery of RTT (referral to treatment times) has been raised as an issue at annual accountability reviews for the past three years, primarily relating to Norfolk and Norwich University Hospital Foundation Trust.'

The N&N says it cannot meet the target for treating 90pc of its orthopaedic and trauma patients within 18 weeks of referral until February 28, 2013.

The PCT has asked why it will take this long, and says in the absence of a compelling case it cannot agree to this timescale. It also wants to introduce penalties of �70 per hour for when ambulances are delayed at the N&N for more than 15 minutes and has written to the Centre for Effective Dispute Resolution seeking their support to mediate in the dispute.

Other concerns raised by the strategic health authority include that NHS Norfolk had the highest C.Difficile rate across the Midlands and East, that all three of Norfolk's hospitals failed to meet A&E performance in at least one quarter, regular mixed sex accommodation breaches by the QEH at King's Lynn and concerns around nine 'never events' in one year, of which four were reported by the N&N. However, it also noted improvements in many areas, including cancer waiting times, stroke, dentistry, maternity, finance and efficiency savings.

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Anna Dugdale, chief executive of the N&N, said: 'In recent years we have, like most other acute hospitals in the country, seen very significant increases in the demand for emergency inpatient care. In spite of the increased demand for our services, we have successfully reduced the overall number of patients waiting over 18 weeks for treatment from 873 in December 2011, to 449 at the end of August 2012. We have agreed with our commissioners that we will meet the national standard to treat 90pc of patients within 18 weeks of referral from October onwards. In Orthopaedics we have agreed to 90pc by March at the latest.

'In a busy hospital like NNUH we are constantly balancing the demands of our emergency and planned elective workload. Any surge in demand for emergency care has an immediate impact on the level of planned care we are able to provide. As such we are working with all our partner organisations in health and social care to explore new ways of caring for patients closer to home where this is in their interests.'

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