Monday 9 October 2017

Beleaguered Tameside hospital boss announces retirement!

Retiring - Paul Connellan, Chairman Tameside Hospital

Although I have been attending the Annual General Meeting (A.G.M), of Tameside Hospital, - now known as Tameside & Glossop Integrated Care NHS Foundation Trust -for a number of years, I'm not sure if I ever learn anything knew. It always seems to me that we get the same message - things are not as bad as you would believe, 'things can only get better.' Watching the hospital bigwigs perform their act, is like watching a stoat or a conjurer in a musical hall. A hospital financial deficit of £13.32m, is dismissed as being better than predicted because we were expecting a £17m deficit. A P.F.I deal that built a hospital facility - Hartshead South - is passed off as "a good financial deal", even though the  repayments are extortionate. Under this P.F.I, investors raised £77.2m and paid Balfour Beatty to build it. From October 2010 to August 2041, Tameside Hospital will have paid back £300m in charges.

At the hospital A.G.M last Monday evening, Paul Anthony Connellan, the Chairman of the Trust since October 2011, announced that he would be stepping down as Chairman, as from 31st October. This sociology graduate, with a background in the travel industry, declared back in 2011 that he had the right skills and experience to get to the root of the problems at Tameside Hospital, such as the high death rates and he was described by former hospital CEO, Christine Green, as a "perfect fit". Almost two-years later, the hospital was  put into special measures in July 2013, following a review by Sir Bruce Keogh, the medical director for the NHS, and consequently, Christine Greene was forced to resign.  The Keogh report stated:

"The Board is not effectively leading the Trust and delivering quality care and the governance and leadership has not delivered the improvements in the quality of care required."

In 2014, the health regulator, 'Monitor', declared the hospital Trust, "Clinically and financially unsustainable in its current form."  While Connellan told the A.G.M. that "What had been lacking for a long time was appropriate leadership and now we've got it," some of us,  who well remember Mrs Green's tyrannical regime at Tameside Hospital, will recognise that what Connellan says, is utter bullshit. Despite her so-called 'inappropriate' leadership, he was part of it, and he backed her up to the hilt, right up to the eleventh hour and many were amazed when he kept his own job. 

After Connellan told the meeting that Tameside Hospital had "an exceptionally bright fututure", the current CEO, Karen James, talked about 'Direction'. The hospital was now  starting to deliver integrated care and had invested £23m to deliver the new model. The hospital had received good CQC ratings and patient's were feeling very positive. It had improved its performance and had launched digital health care. The hospital had opened the Tameside Macmillan Unit and had expanded the Darnton House service. "Staff tells us how much they like working here", declared Ms James.

A number of question were asked about the efficacy of Skype consultations, which have been operating in  30 care homes in Tameside for the last four months. We were told that this had saved 300 A&E admissions at the hospital and that care homes were very enthusiastic. Listening to this, I visualised a fragile old lady in a care home being asked to stick out her tongue by a doctor, sitting miles away, looking at her on his lap top and saying:

"Oh! madam, you're tongue looks heavily pixelated, I think I'd better send for the digital doctor." 

Many of us did wonder how you would take a blood test or check a pulse or the chest of a patient, while doing a skype consultation. But we were assured, that this wouldn't be a problem, because people in the care homes would be trained to do this. Connellan told the  audience: 

"Clinicians will always err on the side of caution. If they think a person needs to be admitted, they will always do so. Elderly people don't always want to go to hospital."

Brendan Ryan, Medical Director, told the meeting that staff and patients were more happy to report incidents and that complaints were going down, with just 450 in 2017. The Trust was reducing the mortality rate - H.S.M.R and S.H.M.I measures and review all deaths at the hospital within 14 working days.

The Director of Finance, Claire Yarwood, presented the annual accounts for the hospital for 2016-2017. "We spent more money than we received", she told the meeting but things were not as bad as they seemed. Although the hospital had a deficit of £13.32m, "We had planned to have a deficit of £17.3m, so we got our deficit down." During the financial year, total operating income was £212.42m and the Trust had made efficiency savings of £8.4m against a target of £7.8m. The P.F.I. - "it's a good financial deal", had to be accounted for separately under 'Financing Costs'. The Director of Finance told the meeting that the hospital was hoping to save money following the introduction of Skype consultations. 

Tameside Hospital is planning to cut 246 beds at the hospital by 2020. If this is implemented, it would leave the people of Tameside & Glossop with 80 beds per 100,000 population against the current UK average of 300 beds per 100,000 population. Hospital management maintain that by treating patients in the community and in their own home, using five multi-disciplinary care teams, demand for hospital beds will decline because health professionals will be able to manage underlying health problems more effectively and prevent hospital admissions.

However, as Professor Michael Marmot points out in his book (The Health Gap 2015), health is related not only to access to technical solutions, but to the nature of society - the conditions in which people are born, grow, live, work and age, have a profound influence on health inequalities in childhood, working age and older age. Karen James, the CEO of Tameside Hospital, believes "We are all living longer." Yet we know, that annual rises in life expectancy, have begun to stall in England and we also know that the regional death gap has widened since 2008. In 2015, the number of premature deaths of people aged 35 to 44 was 50% higher in the north of England than in the South of England. Today, suicide is now the biggest cause of death of people under 50 in Britain and poverty, precarious work and cuts in public spending are all known to have increased the death toll and to have diminished the quality of life for many people.

Tameside Hospital became the first NHS hospital in the UK to set up a permanent food bank collection centre on site, after medical staff reported a significant increase in the number of 'malnourished patients' turning up for treatment and care. This sort of thing is a sad indictment of the type of society Britain has become. We live in the fifth richest country on earth and yet, some of our citizens cannot afford to feed themselves properly. As Michael Marmot says - "health is far too important to be left solely to doctors."

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