We cannot pretend there’s an easy solution to the problem of waiting times in the casualty department at Queen Alexandra Hospital.
If there were, it would be applied; make no bones about it.
But today we report the disappointing news that despite many attempts to reduce the number of people left waiting for more than four hours, little progress has been made.
Since the autumn we have reported on plans to introduce GPs to A&E to help speed the throughput of patients. A new computer system has been purchased that should be able to help staff work more efficiently.
And we were told regular meetings were set up to co-ordinate where beds were available across the hospital, to keep A&E as empty as possible and so prevent patients being stuck in ambulances as there is no room in casualty.
All of these appear eminently sensible, but so far have not taken effect. And indeed, if you compare the number of patients treated on a weekly basis, despite being winter it is not a significantly higher number than last summer. It cannot be said that there has been a spike in demand.
So sadly, this is clearly an area that still needs close examination and, as we have urged before, this examination needs to be done not just looking at the hospital as a whole but looking at health – and social care services – across the area as a whole.
We need to look at the reasons for attending A&E – are GP surgeries’ and walk-in centre hours part of the problem, and are many people being referred unnecessarily by NHS phone helplines? Is there an issue with staff morale? Or time-consuming paperwork?
And one further point. We are not sure that the system of fines is the most constructive for the health service. It may well be the case that the fines are put back into the trust, and are more a case of withholding payment rather than denying payment.
But even so, having reported recently that Portsmouth Hospitals NHS Trust was about to eradicate its deficit and was managing to break even, it is hard to see that squeezing the bottom line will improve the situation for patients.