A performance and quality report to Wednesday’s meeting of NHS Northumberland Clinical Commissioning Group’s (CCG) governing body outlined that the amount of ‘non-elective activity’ is at ‘an unprecedented high’.
This applies not just to emergency departments, walk-in patients and trips by ambulance, but also GP appointments.
In July 2017, there were 109,297 GP appointments (face-to-face, phone consultations and home visits), which dropped to 106,529 in July 2018 before jumping to 127,503 in July this year.
The CCG’s chief operating officer Siobhan Brown said: “It’s quite hard to get under it in terms of what’s driving this in all parts of the system.”
Dr John Warrington, the CCG’s director for planned care, said that the why is key, because quality and improvement takes a back seat if the system cannot deal with the pressures, ‘particularly in primary care where you can’t recruit’.
The report also notes an underperformance against the target for A&E patients being seen within four hours, a recent deterioration in delayed transfers of care and an ‘ongoing underperformance of the ambulance service both at trust-wide and Northumberland level’.
The worst waiting-time performance for the North East Ambulance Service is for category two patients – those who have a serious condition, such as stroke or chest pain.
Ms Brown said: “The ambulance service has been very transparent about the problems they have got, particularly in relation to category two.”
She outlined various work the CCG itself had been doing to support NEAS such as looking at a community paramedic scheme like already exists in Berwick for the whole county and focusing on pathways between the Northumbria hospital in Cramlington and the Newcastle hospitals.
“It’s not sorted by any means, but we are taking a lot of action to try to deal with it,” she added.
But there were also positives within the report, for example, from a cancer perspective, there are increased numbers of people being diagnosed within 28 days, which is to be introduced as a formal target next year.
Currently, 85% of cancer patients should be treated within 62 days of a referral by a GP.
The report says: ‘Northumbria (Healthcare NHS Foundation Trust) has reduced its time to diagnosis of cancer significantly across a range of procedures that has been reflected in the July performance data resulting in the CCG achieving the 62-day target for the first month for a long period of time.’
With regard to overall referral to treatment times, there is an average improving reduction in waiting times, although the numbers of patients on the waiting lists are still going up.
The target is that 92% of patients should not wait longer than 18 weeks to be seen and in June, the CCG achieved this threshold.