Daily Insight: The handover nine

The government signalled in its autumn statement that ambulance response times will be treated as a primary performance indicator for health systems – which has not always been the case.

Crucial to improving response times will be the efforts to reduce delays when ambulances arrive at hospital and attempt to hand patients over to emergency staff.

These delays have skyrocketed over the last year, but new analysis by HSJ suggests the problems are largely driven by a small number of trusts in the South West and East of England.

There were nine trusts in England where, for each ambulance arrival in the week to 20 November, an average (mean) of more than an hour was lost to handover delays. The providers accounted for around 7,000 hours lost, 33 per cent of the national total, despite only accounting for 7 per cent of ambulance arrivals. 

At University Hospitals Plymouth an average of 2.3 hours were lost.

The delays are often caused by the hospitals struggling to discharge patients into the community, meaning their wards are full and emergency departments overcrowded.

However, much of the country faces similar difficulties, and at many trusts there were relatively low numbers of hours lost, including at some of the largest emergency providers, such as Leeds Teaching Hospitals and Newcastle Upon Tyne Hospitals.

Transformation blues

The Care Quality Commission’s latest monthly staff survey has highlighted again how difficult implementing its transformation programme has become.

Of course, change is rarely popular, but the CQC’s autumn People Pulse survey has pointed to an unhappy workforce, with not just concerns about the new inspection regime but also the lack of care their employer has for their health and wellbeing and its approach to inclusivity.

The results have taken a turn for the worse when compared to a similar survey done last year, with the operations team – who made up the majority of respondents – the most frustrated of all employee groups, with their results worsening on almost every measure.

This follows news a few months ago that the CQC has launched an internal review into how it responds when given “information of concern”, along with a barrister-led review into a high-profile whistleblowing case.

CQC chief executive Ian Trenholm said he was sorry the experience of the transformation programme had been bruising for staff and said an advisory group had been created across the organisation to help share “learnings” from happier teams.

All eyes will be on the regulator’s main staff survey which is ongoing, with results reporting early in the new year.