Region ordered to improve its emergency units
TWO years after Greater Manchester signed its groundbreaking health devolution deal the region has been ordered to improve its A&Es by government.
Latest figures show all but one of our hospital trusts are missing emergency targets laid down by Whitehall under 2016’s deal.
Several local hospitals are also facing massive deficits while Greater Manchester councils have raided £66m in reserves this year to fund social care.
It is a situation that has raised significant questions over whether ministers gave our region enough money to pay for the new system in the first place.
One hospital trust has described ‘extreme’ and ‘immense strain’ on its A&E because of rising numbers of frail, elderly patients with complex conditions requiring a lot of medical attention and a longer stay in hospital.
In some areas exhausted staff, completely committed to their communities, are struggling to cope.
Greater Manchester’s devolved health system took effect on April 1, 2016, with its terms stating that 85pc of patients must be seen at A&E within four hours.
Below that level, government has the option to ‘step in’ and take the reins.
Despite a range of other improvements since devolution – including in cancer and stroke care – in February the region’s figure stood at 83pc.
Two local trusts, Stockport and Wigan, ranked in the bottom 10 per cent of performers nationally.
Jon Rouse, the region’s chief health officer, confirmed that, theoretically, national health bosses could ultimately choose to intervene as a result.
He said: “There are trig- ger points within the system which if we fall below – depending how far we fall below – NHS England can either request an improvement plan or, in extremis, they could decide to intervene and step in to the situation.”
Greater Manchester had been in breach of its fourhour target ‘for some time,’ he said, adding that while its performance was not unusual in terms of the national picture, its devolution deal makes it unique.
“Only Greater Manchester is under a devolution agreement with this type of accountability standard and I think NHS England have made a judgement that it’s reasonable to ask us for an improvement plan,” Mr Rouse said.
“Given that we’re not behaving very differently from the rest of the country, I don’t think they’re in a position where they’re considering ‘step-in,’ but they want to know what we’re doing to try to improve the situation. And from my perspective that’s fair enough.”
The ‘principal driver’ of the situation had been high numbers of medically sick patients needing urgent hospital care, he said, adding: “The issue is the number of people with high acuity coming in the front door over the winter period.”
However, he pointed to three underlying challenges faced by the region in improving emergency waiting times.
Many of Greater Manchester’s A&E units are ageing and physically too cramped, he said, and while some ‘little bits of capital funding here and there’ have been provided by government, a new bid for money is now being drawn up so the departments can handle ‘a totally different number of people.’
“Some of the A&E departments are just too small for the number of attendances and the patients with high acuity coming through them and that is a real problem,” he said. At the same time, in common with other parts