According to the East Kent Hospital University Foundation Trust (EKHUFT) eastkent_annual_report_and_accounts_2015-16-page-11 The Trust has over 1000 beds including 27 critical care beds and 67 children’s beds. Its 7,500 plus staff provide a range of core and specialist healthcare services to a population of over 750,000 across east Kent. The Trust receives over 200,000 emergency attendances (27% of population), 94,000 inpatient spells (12.5% of population) and 727,000 outpatient attendances per year (97% of population). There are 138,000 day case attendances (8.1% of population).
EKHUFT provide this across five hospitals including the William Harvey in Ashford, the Queen Elizabeth Queen Mother in Margate, Buckland in Dover, Royal Victoria in Folkestone and Kent and Canterbury in Canterbury city. The Trust also provides health services from other NHS facilities across East Kent including renal services in Medway and Maidstone.
EKHUFT like many other trusts receive a lot of criticism, but it like others hasn’t really stopped undergoing massive, systemic changes since the late 90s, and now it seems to be at breaking point. Doctors and nurses are buckling under the pressures of dealing with more patients with fewer resources, and politicians changing the rules every few years.
The most obvious and immediate problem is one of funding. Despite assurances to put more money into the NHS, the previous six years have cut funding in real terms, and on top of that NHS organisations are being asked to make sizable ‘efficiency savings’. After the longest sustained period of underfunding in its history the NHS is struggling to keep afloat, leading to a very large £35.2 million budget deficit (2015/16) at EKHUFT according to the accounts for 2015/16 (page 6 of pdf above)
What this inevitably leads to is a drop in the quality of care, which comes back around to make the financial situation worse. If you’re running a bare-bones service then a bad day for hospital admissions is a crisis. Agency staff have to be rapidly recruited, fines start to accrue from the local clinical commissioning group (CCG) because patients are left waiting in the corridors, and scheduled operations have to be cancelled, meaning a loss of income.
Nearly every doctor and nurse works longer and harder than they have to, but after so much stress and upheaval, and without much of a plan to solve it, patience is starting to wear thin. Not only are more people taking themselves off the payroll to take advantage of the higher rates they can command from being agency workers (EKHUFT is trying to reduce it’s reliance on agency workers) or locum doctors, but more people are leaving altogether. . All this comes during a national recruitment crisis for doctors and nurses.
Is this any wonder when the ekhuft-annual-staff-survey of EKHUFT (2015), put stress at work above the national average, along with bullying, staff engagement, a lack of involvement and that staff do not look forward to going to work.
Someone might be able to fix it, will it be the EKHUFT new Chief Executive Matthew Kershaw – Salary £230,000 plus (left)? If only the NHS was in a stable enough condition for him to do so. Even three years after their creation, clinical commissioning groups (ours is the South Kent Coast CCG, headed up by Hazel Carpenter Salary £112,875 p.a.(below left)) are still working out how they can effectively manage their local areas.
Increasing marketisation and privatisation is also taking its toll, forcing the NHS to compete for contracts with private providers and requiring a small army of lawyers, contract managers and administrative staff to deal with them.
The only ‘solutions’ offered by government are ‘Sustainability and Transformation Plans’ (STP). These clump the CCGs and trusts of 44 regional ‘footprints’ to develop strategic plans, which seek to ‘rationalise’ their component services, often by getting rid of some. Despite being in development for the last nine months, only a select few have any idea what’s in store for East Kent. The plans are so secret that not even SDC’s Cllrs, Jennifer Hollingsbee & Michael Lyons who site on the South Kent Coast CCG member for health is allowed to know, let alone you or us.
So when the STP for East Kent is released, this vastly condensed infographic should leave you better equipped to ask: Which problems does it solve? Which does it make worse? Because bad choices in the NHS ultimately mean two things: more people living in pain and more people dying early.
Part of this blog post was first published by Sid Ryan – The Bristol Cable