One star status, what effect on hospital

IPSWICH Hospital NHS trust has been downgraded to just one star – but what does that mean and what does the future hold?

JESSICA NICHOLLS talks to Chris Dooley, the top man at the hospital to find out.

HARDWORKING staff at Ipswich Hospital NHS Trust are still struggling with their disappointment today after NHS performance figures revealed the trust had been downgraded.

Last year, in line with much of the rest of the country they were awarded two stars, so what in the past year has gone wrong?

According to Mr Dooley, acting chief executive at the hospital it is all about waiting times, staff levels, beds and the need to modernise the service.

Yes, last year may have been something of a struggle but things are already looking up and plans are already being laid for a brighter future.

Yesterdays NHS performance ratings (as reported in later editions of last night's Evening Star), showed that the trust had received an average status in most of the nine key areas but had fallen under the set guidelines for two week cancer waits ie: where there is strong suspicion that a patient has cancer they should see a consultant within two weeks.

However it is a complex issue. Many areas were investigated from staff hours and sickness absence to finance issues to the amount of hours a patient waits on a trolley.

And as Mr Dooley pointed out, it only takes one area for the trust to significantly under achieve to ensure the hospital cannot carry on to the next level of assessment and therefore can only be awarded one star.

In fact, the trust only just missed out on being able to carry on to the next level, with just one or two suspected cancer patients failing to see a consultant within the specified two week period.

The system may seem a little unfair in that respect but as Health Minister Alan Milburn stated: "The public has a right to know how their local health service is performing.

"The NHS does not belong to me. It belongs to the people who use it and pay for it."

Therefore the hospital is there to serve the public and it cannot be below par.

Financially Ipswich have lost out because those awarded three stars are to receive an extra £1million and more freedom in deciding what should be happening in their trust rather than constantly having to answer to Whitehall.

In the long run though Mr Dooley does not believe that getting a one star status means they are going to get less funding in the future.

Now their main aim is to boost their service and in turn the performance ratings and cancer waiting times are their main target for the immediate future.

Mr Dooley said: "The first thing we have to do is to ensure that we meet as closely as possible the cancer two week waiting times.

"There are already measures in place to hopefully see a big improvement by the end of October.

"There is a very fine dividing line (for the ratings criteria) and we were only three percent out to get to the next level."

Also to fall below average was the hospitals ability to stick to the 18 month inpatient waiting times, although only one patient waited more than that time for treatment and according to Mr Dooley that was through patient choice.

On the bright side, many targets were met, no patients were left waiting more than 15 months for treatment and all new patients waiting for an outpatients appointment were seen within 26 weeks.

Breast cancer treatment was significantly above average and so were staff and patient surveys to find out exactly what the people using the service want to see.

So why did the trust receive a two star rating last year but not this year?

Mr Dooley said the problem mainly arises because of capacity levels at the hospital.

He said: "We saw an increase in patient referrals last year and did not have the capacity ( beds, staff etc) to meet that demand.

"We are working with Primary Care Trusts to work through the best solutions in addressing this.

"Obviously if we can deliver that as a target during this coming year that will go some way to improve our performance."

It is not known exactly what will be included in the star rating targets for next year but work is being carried out to try an predict what might be there.

But Mr Dooley suspects that one of the major targets will probably be the issue of waiting times.

The hospital are already trying to find solutions to help reduce waiting times across the board, not just with cancer patients, but it is not simply to do with having the right amount of beds and staff to deal with the influx of patients coming through the doors.

Working practices within the trust are now being improved.

Mr Dooley said: "Although beds and staff are very important there are ways that we can work with the PCTs to organise our services."

Currently work is in progress within the ENT (ear nose throat) department where patients are seen out in the community rather than having to join hospital waiting lists.

New plans are also going ahead in the form of the IDEA project which is intended to give patients faster access to the services they need.

One example of this is having consultants on the front line in A+E who can assess a new patient on arrival to see what treatment they are likely to need which will hopefully see an end to lengthy waiting times.

Also in a bid to modernise services, the issue of bed blockers and the time taken to discharge a patient has come to the fore.

Mr Dooley said: "We want to make sure that tests are done at the right time and come back at the right time to speed up the process.

"It is all about improving the patients experience in hospital."

Many beds are being taken up by people waiting for tests and then having to wait for the results.

Much hard work is going on to ensure the star ratings will be better for next time round but Mr Dooley recognises that improvements cannot happen overnight.

But it is intended that in the next 24 months, the trust will be in a position to achieve the coveted three star status.