Health trusts will work together to enhance care and improve QA's emergency department

A TASK force is to focus on ending the long-standing problems at Queen Alexandra Hospital's A&E department.

Monday, 21st November 2016, 6:05 am
Updated Tuesday, 22nd November 2016, 12:06 pm
Ambulances outside the A&E department at Queen Alexandra Hospital, Cosham

The A&E Delivery Board will see health trusts from across the Portsmouth area meet and work together to provide more efficient services, with a special emphasis placed on easing mounting A&E pressure at the Cosham hospital.

It comes as QA’s A&E department continues to be one of the worst-performing in the country.

Last month, 74.3 per cent of patients were treated in four hours or less, way off the national target of 95 per cent.

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The hospital was also placed on ‘black alert’ last winter due to a struggle to cope with the crippling demand, which saw ambulances queuing outside and fears QA was at breaking point.

The new A&E Delivery Board – which will include councils, clinical commissioning groups and community care providers – has replaced the Systems Resilience Group.

The aim is for all services to provide more efficient care, which it is hoped can ease the strain being put on QA’s A&E department, especially ahead of higher numbers of patients expected this winter.

Portsmouth South MP Flick Drummond said it was a big step in the right direction.

‘This is a move that will make a big difference to how winter pressures in the NHS in Portsmouth will be handled and I welcome it,’ she said.

‘All these agencies, using their expertise and resources to work together, should have a substantial influence on how issues like A&E visits and, crucially, bed-blocking are handled.

‘The hope must be for fewer bed-blockers when the NHS is under pressure during these winter months.

‘Anything that can lessen the amount of visits to A&E must be explored.

‘Of course, there will continue to be pressures and this not a magic wand, but it is a big step in the right direction.’

Gosport MP Caroline Dinenage also supported the board. She said: ‘Given the recent well-documented pressures on our health services, it seems extremely sensible for them to collaborate and communicate as effectively as possible in order to drive improvements.’

Fareham MP Suella Fernandes agreed. She added: ‘We have seen serious pressures in A&E where there have been long delays and issues of processing patients.

‘The A&E Delivery Board is a step in the right direction – I hope it provides a more efficient and integrated service that delivers a safer and better quality of care for patients.’

The board’s first meeting was held in September and chaired by Dr Jim Hogan, the clinical chief officer of Portsmouth CCG. Members have been meeting regularly since.

Dr Hogan said: ‘Despite its name, the A&E Delivery Board is focussing on a whole system delivery – A&E is just a barometer of what is happening across our area.

‘We are looking at whole system performance and operational resilience – not just meeting the four-hour waiting target for patients.

‘This is about providing safe services for our patients and effective and prompt care in appropriate settings which meet each individual’s needs.’

Dr Hogan added that the organisations will work together to minimise both inappropriate attendances to the emergency department and hospital admissions.

‘We also want to avoid delays to discharging patients who are well enough to leave hospital,’ he added.

He said their key functions are to ensure they plan for the number of patients that may need healthcare and understanding the pressures.


A COUNCILLOR has said the future of sustainable healthcare is in the community rather than hospitals.

Councillor Luke Stubbs, cabinet member for adult social care and public health at Portsmouth City Council, said it is important the A&E Delivery Board looks at the future of services while also resolving current problems.

‘Every organisation needs to work together to co-ordinate what they do as a board,’ he said.

‘We recognise that there are problems with the hospital and that we need to work together to resolve them.

‘Portsmouth City Council is a fair bit higher than the national average at getting patients out of hospital, but we recognise we can do more.’

Cllr Stubbs added that, in the future, more care needs to be done in the homes of patients rather than in hospitals.

He said: ‘In the long run we need, if the health and care system is to be sustainable, to come up with a working model where we spend less of our available money in hospitals and more in community care.

‘All patients would prefer to spend time out of hospital, they do not want to be in hospitals.

‘We know for most patients they have better outcomes if recovering in a community setting.

‘The aims of the board has to be to bring that about and move towards a model of care more in the community for the future.’


February 24: South Central Ambulance Service raises concerns that its crews are being held up at the hospital’s A&E department. It comes as 16 ambulances are left queuing at the hospital with some patients waiting for two hours to be handed to staff at QA.

March 5: Leader of Portsmouth City Council Councillor Donna Jones calls on health secretary Jeremy Hunt to take action and fix problems at the hospital.

March 9: The Firefighters’ Union says lives are being put at risk as ambulances are delayed in handing patients over to staff at QA.

March 14: Plans are put in place to fix the issue of bed-blocking at the hospital. They are agreed after Portsmouth North MP Penny Mordaunt meets with hospital chiefs.

April 29: Care Quality Commission (CQC) tells bosses at QA that A&E must improve immediately. Four conditions are imposed on the hospital’s A&E department to ‘reduce the risk of patients being exposed to harm’.

June 9: CQC publishes a damning report on the emergency department at QA, rating it as inadequate.

September 14: Day surgery patients are transferred to St Mary’s Hospital from QA to improve waiting times.

October 24: Ambulances are left queuing outside A&E with at least 10 waiting to hand over patients.

October 31: Two elderly women are left waiting a combined total of 23 hours for an ambulance as QA Hospital is put on black alert.