• Medway FT had poorest overall four-hour performance in south east and poorest type 3 performance in England
  • Type 3 services usually help to raise trusts’ overall performance figures
  • Board papers reveal trust is under pressure from regulator over poor type 3 performance

A social enterprise’s poorly-performing type 3 service is weighing down an acute trust’s overall accident and emergency performance – and getting it into trouble with regulators.

Medway Foundation Trust had the poorest performance in the south east with just 73.3 per cent of patients seen within four hours in June, figures released last week revealed.

But, whereas many trusts had their figures boosted by type 3 performances – many services had performances well above 90 per cent and often at 100 per cent  – the type 3 services in Medway saw just over four out of five patients within four hours. These figures were attributed to Medway FT in the official statistics, despite the service – called MedOCC – being provided by Medway Community Healthcare, a social enterprise.

At 81.3 per cent, MedOCC’s service had the lowest type 3 performance in the country, with only two other type 3 services performing lower than 90 per cent. More than 500 people waited more than four hours for type 3 services at sites in Medway and Swale last month.

Around a quarter of the 10,404 patients included in Medway FT’s overall figures were seen by the type 3 services. Had these services obtained the national average performance of 98.9 per cent, it would have raised the FT’s overall performance to around 77.9 per cent.

’Under the radar’

Medway FT’s latest board papers highlighted concerns MedOCC’s poor performance had slipped “under the radar”, and added the trust is under considerable pressure from the regulator to bring type 3 performance up to acceptable standards.

The trust has recently taken on validation of the breaches in type 3 attendances, which was previously being carried out by MCH. The trust’s board papers suggested this has driven a deterioration in the reported position for type 3 of around 7 per cent. 

While the service’s satellite units at Sheppey Community Hospitals and Sittingbourne Memorial Hospital were seeing more than 99 per cent of patients within the four hours, the colocated service at Medway Maritime Hospital was regularly below 80 per cent, according to the paper. 

Until recently, a walk-in centre at the Balmoral Gardens Healthy Living Centre in Gillingham was also included in the figures, but this closed at the start of July. Medway Clinical Commissioning Group, which consulted on the closure, said extra GP appointments at the weekend and evenings would help meet some of the demand. However, HSJ has been told that, since the closure, the type 3 service at Medway Maritime Hospital has seen significantly increased demand.

Stuart Jeffrey, deputy managing director at Medway CCG, said that the additional patients had been anticipated and MCH had raised staffing levels accordingly.

In a statement, MCH said: “We recognise, at certain times, the waiting times for MedOCC have exceeded the four hour target. We’ve increased staffing levels to take account of the additional demands on the current service and we are continually monitoring this on a day to day basis.”

Medway FT’s chief operating officer Harvey McEnroe added: “We are working alongside MCH and Medway CCG to address the issues experienced recently in MedOCC. The trust will be reviewing progress to ensure that the actions being implemented lead to a sustained improvement in performance and an improved experience for our patients.”