IT has been an ‘incredibly difficult year’ for Warrington Hospital, according to its chief operating officer.

Simon Wright, who is also deputy chief executive of Warrington and Halton Hospitals NHS Foundation Trust, was speaking about some of the difficulties the hospital and especially its A&E have faced over the year.

It comes after it was revealed that for the first time, the trust has failed to meet the 95 per cent target for patients to be treated, admitted or discharged in four hours for all but one month since March last year.

“The trust has traditionally always delivered its four hour target but this year that’s just finished has been the first time that we’ve not been able to do that,” he said.

“We have put a great deal of effort into trying to understand what is preventing us from achieving that.”

Mr Wright outlined several reasons why the trust had struggling including an increase in the number of elderly and frail people and very poorly patients that take longer to treat coming into the department.

They also can take longer to discharge and Mr Wright said they do often struggle to secure care in the community provided by social services and the local authority.

“So because there have been a few delays in securing that support that might mean that patients stay in the hospital a little bit longer,” he said.

“If you have more people who are fairly old who need those services then inevitably you start to create queues and that is what we have seen.”

But he also explained that the hospital had changed the way it treated people with conditions such as unexplained stomach pain, treating them in between six and eight hours in A&E instead of admitting them to hospital for several days.

He said: “We could admit you into a hospital bed for two days in two hours and we’re not breaching the target or we could treat you and discharge you home in five hours but you are breaching.

“You would probably prefer the five hours and going home but unfortunately the rules mean that we can exclude them from that count.

“It is a perverse incentive unfortunately, we are doing the right thing but we are being penalised because of it and it is nobody’s fault it is just the way the system has been established.

“As a consequence, our A&E has the lowest admission rates in the region at 20 per cent but it does mean you have got more people staying in the A&E a bit longer.

“I think the target unfortunately at the moment doesn’t promote all the work that we are doing as a health system to manage demand and I think if it were to better reflect that I think everyone would see the target slightly differently.

“We have had to work very hard at the things we need to change so that we will be more successful in 2015 than we were in 2014.”

But despite the pressures the hospital faces, Mr Wright is full of praise for it’s staff.

“I want to say is a massive thank you to all the staff both in the hospital, in the A&E but also social services and the district nurses in particular and the GPs.

“It has been an incredibly difficult year, this has been the hardest year I have experienced since joining the health service. It has really been tough and I think they have done an amazing job.”

Steps taken to relieve A&E pressure

SEVERAL new initiatives have been introduced to try and relieve the pressure on A&E.

The trust along with its commissioners and the council has spent £800,000 opening the Daresbury Unit which provides somewhere for patients waiting for community care to go to free up beds.

The hospital has is also working on changing a surgical ward into a medical one after and new process of assessment has seen a drop in people being admitted through emergency surgery.

Instead of being admitted to surgical ward, patients will be assessed by a surgical team in an assessment unit, meaning tests can be carried out in a few hours instead of several days.

Simon Wright said: “I think the combination of those two things is just starting to allow our A&E to have an easier time.

“We are looking to do some more work at the moment with primary care to look at a different way of managing some of those patients that will attend the A&E who probably really don’t need to and see if we can decongest our A&E a little bit that way.

“One of the ways we have done it in this last year is by partially opening an urgent care unit in Halton which will open fully in July.”

The trust is also looking to work with charities around the support that they can offer to older people to try and help prevent them deteriorating and ending up in hospital as well as moving more services in to the community such as some diagnostics, respiratory medicines and heart failure.

What we can do to help

THERE are several things that Simon Wright says residents can do to help A&E.

He explained that 2,000 extra GP appointments were put into the system in February and that people needed to make sure they tried to get an appointment before resorting to A&E.

Similarly, he feels that people could make better use of pharmacies in the town which can offer advice and medication.

“I think on a broader footprint there is just something about looking after yourself a bit better really,” he said.

“I think it is only as they get older and start accessing healthcare services that they wish they hadn’t smoked or cut down on my smoking and my drinking or had done a bit more exercise.

“Those are the sorts of things that we need to try and find ways of promoting really, being slightly healthier, looking after yourself and being a bit more carefully with the things that we do.”

Facts about the A&E

• 104 to 106,000 people come through A&E and the trust’s Halton unit a year

• The trust has seen an increase in the number of patients in their 90s and had patients celebrating their 100th birthdays

• Nine out of 10 people this year will have been seen on average in about two and a half hours in A&E

• The trust has employed two new A&E consultants, bringing its total to 10, two more than the national average of eight, and 10 new nurses in the past year