Critical report by East Lancashire A&E shake-up architect
7:10pm Monday 5th October 2009 in Search
CHANGES: Professor George Alberti
A CRITICAL report into East Lancashire’s A&E shake-up by an architect of the plans has been revealed for the first time.
Professor George Alberti, a government A&E expert, was a key figure behind the closure of Burnley’s blue light service in November 2007 and the re-directing of all 999 cases to the Royal Blackburn Hospital.
But, after meeting with health bosses, doctors, nurses and patients in January, the professor produced a report for the National Clinical Advisory Team in March strongly criticising the way the switch was managed.
He claimed there had been a decrease in beds and staff – an allegation denied by the hospital.
Prof Alberti said: “I had not anticipated a decrease in beds or staff but rather a change in function and redistribution.
“In reality there was a considerable decrease in both beds and staffing, which has exacerbated some of the problems.”
Prof Alberti’s report was not made public at the time.
Pendle MP Gordon Prentice, who is campaigning for an independent review on the issue, obtained a copy via a Freedom of Information request.
He said: “It deserves a wide readership.
“It makes depressing reading.
“The professor tells us what we already know and a bit more.
“While still maintaining the original reorganisation model is valid, he says the programme management arrangements set up in 2006 ‘seem to have fallen somewhat into disuse’.
“This is an astonishing admission given the raging controversy about the changes.”
The report comments on East Lancashire Hospitals Trust’s ‘consistent’ failure to meet the four-hour emergency wait target but praises its ‘striking’ improvements in clinical outcomes for patients, including lowering death rates for cardiac patients in hospital and within 30 days of their discharge.
However, Professor Alberti also identified ‘a failure to implement key elements of the required service changes’ and ‘inadequate management of patient flow and capacity’.
The report also cites NHS East Lancashire’s ‘slow’ development of integrated community and primary care services.
He said: “In retrospect these developments should have proceeded the hospital changes.”
>>> Health chiefs: No reduction in number of beds
HOSPITAL bosses say there was no decrease in hospital beds or staffing as part of the A&E shake-up.
The East Lancashire Hospitals NHS Trust said there were a number of vacancies at the time of the report which have now been filled.
Health chiefs also pointed out that there was unprecented demand for services last winter, leading to a series of problems.
Lessons will be learned this year, the hospital has vowed.
The trust, working with primary care trusts NHS East Lancashire and NHS Blackburn with Darwen, has since introduced many of the changes recommended by Dr Alberti, a spokesman said.
These include daily ‘hot clinics’ in a wide range of specialties, allowing GPs to refer patients directly to the hospital for a same-day or next-day consultation, bypassing emergency assessment.
GPs can also refer patients who need urgent operations directly to the Surgical Triage Unit, which opened six months ago.
Those who need urgent further investigation of a medical problem can be sent to the Clinical Decisions Unit for assessment by senior clinicians.
A separate children’s area of the emergency department has been set up, and a consultant paediatrician specialising in emergency care appointed.
Lynn Wissett, deputy chief executive of East Lancashire Hospitals NHS Trust, said: “East Lancashire Hospitals, along with our health economy partners, welcomed Dr Alberti’s report back in January, and the trust was already implementing many of its recommendations before it was published.
“Since then, further big strides have been made in improving our hospitals.”
