Doctors warn QA that it is failing some patients

Ursula Ward
Ursula Ward
QA Hospital. Picture: Will Caddy

Hospital boss warns of ‘great pressure’ at Portsmouth A&E in busiest weekend before Christmas

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THE woman in charge of Queen Alexandra Hospital has been delivered a damning message.

Three separate letters have been sent to Ursula Ward, chief executive of Portsmouth Hospitals NHS Trust, which runs QA, highlighting concerns about patient care.

The letters were sent by the leads of the Portsmouth, Fareham and Gosport, and South Eastern Hampshire Clinical Commissioning Groups (CCGs) last month.

Jim Hogan is the lead for the Portsmouth CCG and in his letter he said he has ‘no confidence in your organisation’s leadership capability to achieve good quality and, most importantly, sustainable services for our patients.’

Dr Hogan also says he is writing on behalf of doctors to ‘express our significant concerns about the capability and the commitment of Portsmouth Hospitals NHS Trust’s current leadership to deliver the improvements and service transformation that is required for people in Portsmouth’.

He says he will be raising the trust’s performance with higher authorities – NHS England and the NHS Trust Development Authority.

It comes as the trust has been missing national targets in some areas of cancer care, waiting times for elective surgery and at its A&E department.

And October results of the Friends and Family Test – a survey to see if patients would recommend services – found the trust scored the lowest in the country.

Dr Hogan said: ‘It started with the A&E performance, which was the first thing that went off.

‘Then we saw some other areas of concern, and lastly the score from the Friends and Family Test.

‘From my perspective, this is very worrying – especially after hearing stories from patients in our practices.

‘I felt therefore that one accountable officer, myself, needs to write to another accountable officer, and express concern,

‘Even if there was an improvement, it wasn’t sustained.

‘This is not good, especially with the challenges we face with funding and how we are moving out into the community.’

The CCGs said they are worried the trust is missing national targets. They can hold back funding.

Dr Hogan added: ‘If we see targets going off, then as part of contracting rules, we talk to them about how they will get back on track and have a plan.

‘If this doesn’t work, then we can financially penalise them – but of course we don’t do this for long. We know staff and clinicians are working very hard.’

A letter from Dr David Chilvers, the clinical chairman of the Fareham and Gosport CCG, says that people have a high regard for QA.

But he goes on to write: ‘However, there are some worrying trends re-emerging once more.

‘Failing standards of clinical care and performance are evident... and I am writing to express our concern.’

The trust said it is aware of the problems, but believes the whole healthcare system needs to be looked at.

Peter Mellor, director of corporate affairs and business development for the trust, said: ‘We have had concerns about these things for quite some time.

‘But it’s about the whole healthcare system, as we are in it together.

‘You need to look at the start – GPs – the middle point, which is us, and at the end social services and community providers.

‘We have enacted changes, and they work, but I’m aware things are volatile.

‘However I want to reassure patients that clinically we are superb.

‘We have among the best in clinical outcomes, and this is a world-class hospital, but we need to make improvements.’

The News contacted Ms Ward, but she was unavailable for comment.

GPs outline areas of concern that need addressing

A letter sent by the head of the Portsmouth health group that funds services in the area outlines a number of areas of concern at Queen Alexandra Hospital.

Jim Hogan, the clinical lead at the Portsmouth Clinical Commissioning Group, wrote that in cancer care there are worries about quality of care and the length of waiting times.

He also states that elective surgery waiting times are too long, and that the casualty department is also well behind the targets it should be hitting. Another point he makes is that the Friends and Family Test, which asks whether people would recommend QA, was the lowest in the country in October.

Dr Hogan also points out that these subjects have been flagged up many times before since CCGs were created in 2012, and even before then.

He says that he believes the staff ‘demonstrate a high degree of professionalism’ and that this is a ‘leadership challenge’.

Governors were unaware of letters

MEMBERS of the council of governors at Portsmouth Hospitals NHS Trust say they were not aware that critical letters had been received from three local Clinical Commissioning Groups.

The letters, stating commissioners have ‘no confidence’ in the trust’s leadership was sent to Ursula Ward last month.

While the council of governors do not appoint the PHT’s chief executive – that is decided by the Trust Development Authority – it can advise the board of directors.

It was not given any correspondence over the letter sent to Ms Ward.

One of the council’s members, Councillor Will Purvis said: ‘I was not aware a letter had been sent, and I don’t think anyone else on the board did either. The fact it has come from the commissioners is very concerning.

‘I take it far more seriously with the CCGs compared to the former primary care trusts, because CCGs are made up of doctors, who are frontline and deal with patients.

‘It’s very serious if they have lost confidence and making me question if the trust can meet the standards.

‘It’s disappointing though, that some CCG members sit on the council of governors, and they did not come to meetings to tell us.

Councillor Peter Edgar said he was not aware of any problems.

He said: ‘When Ursula took on the job of chief executive,it had massive challenges to deliver a super hospital, especially as there was a complete modernisation of the system with Haslar closing and changes at St Mary’s.

‘It is a concern there are problems in these areas, and it hasn’t been raised at any of the health boards I attend.’