A safe staffing report has revealed the level of disruption caused by covid-19 at the South Tees Hospitals NHS Foundation Trust.
The report, which focused on July, said staffing had been “challenged” across the trust, which operates Middlesbrough’s James Cook University Hospital and Northallerton’s Friarage hospital, with covid sickness and self-isolation absences due to the virus being described as significant.
It said staff at ward level spoke of being “stretched”, adding: “Staff are feeling tired and increased numbers of junior and temporary staff together with frequent redeployment to maintain patient safety has proved difficult for some wards and departments.”
The so-called average ‘fill rate’ among registered nurses and midwives working day shifts on wards dropped to 89%, down from 91.2% in June and 92.7% the month previous.
These averages were even lower in some instances when it came to night shifts with average fill rates in some wards/departments falling as low as 46.9% and 58.8% during July.
A total of 125 ‘red flag’ events were recorded in July, a major increase on the 53 recorded in June, with a shortfall of registered nurses in some areas accounting for 106 of these.
There were also two instances in this category where there was a delay in providing pain relief to patients and two further instances where vital signs were not assessed and recorded.
The report said: “Short notice unavailability across the whole trust was significant during mid-July when track and trace notifications were at a peak.”
It said more nursing staff were being recruited to fill vacancies with 85 student nurses and six midwives having been due to take up their first post with the hospital trust this month.
A separate integrated performance report presented to the trust’s board at a recent meeting described a surge in the coronavirus in July with the trust “escalating its response”.
It said: “Clinical teams focused on treating patients with covid-19 and those without covid, whose needs are equally urgent, while working to address the needs of anybody whose non-urgent care has been disrupted by the pandemic.”
The report, which also covered July, said elective outpatient and inpatient recovery time was reduced due to covid-related staff absences and redeployment of staff impacting on operating theatres.
The percentage of sickness absences among all staff was 5.41% in July, against a target of 4%, the fourth successive month when there was a rise.
Key areas of concern were stress, anxiety and depression, the report said.
Meanwhile, 31 non-urgent operations were cancelled in the month.
Performance against the Government’s four-hour standard wait target in the accident and emergency department declined, with only 78.1% of people attending being seen and discharged within this period, against a target of 95%.
The report said A&E activity had been in excess of pre-pandemic levels and described “sustained increased demand”, and a lack of cubicle space for patients.
Speaking at the board meeting and referring to the A&E target, Rob Harrison, the trust’s managing director, said: “We are mirroring the national average, but this is not where we want to be and there are a number of [improvement] actions in place.”
Mr Harrison said the performance report was a “mixed picture with real positives, but some areas are struggling”.
He said: “We’ll get a clearer picture on what our recovery starts to look like as the position stabilizes through August and into September when people are back from leave – September will be a critical month.”
There were some positives with both the overall experience of inpatient and outpatients, as assessed in surveys, being above trust targets, although this was not the case in the A&E and maternity departments.
There were also 35 formal complaints received by the trust in July, said to be a significant increase on the previous month.
Ada Burns, the trust’s deputy chairman, said complaints were being closed by the trust in a timely way.
However she said equally important was feedback from complainants as to whether they felt satisfied with the outcome.
She asked Mr Harrison: “Do we measure it and are you comfortable with the performance?”
The managing director said: “We are much better at saying sorry and apologising appropriately now, I don’t think we were doing that very well at all [before].”
Another trust official said feedback was received from complainants, but said more robust processes were needed and as a result the trust was taking part in a national pilot scheme aimed at improving complaints processes.
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