Rishi Sunak MP says “no easy way” to save A&E at the Friarage Hospital

Richmond MP Rishi Sunak says there is no easy way to save the accident and emergency unit at the Friarage Hospital.

The MP says the problem lies in doctors not wanting to work at the Norhallerton hospital rather than a lack of money.

Mr Sunak spoke out today after a decision by health bosses to downgrade A&E department to a 24/7 urgent treatment centre.

Health chiefs say the move is temporary due to staff shortages.

The MP said he shared his constituents’ concern about closure of critical care services at the hospital.

He said: “Like them, I rely on and care deeply about the Friarage. Since being elected as Member of Parliament for this area, my highest priority has been to ensure the Friarage remains a strong local hospital, so this announcement is extremely disappointing to me personally.

“It is also very frustrating that this change has been sprung on us by the South Tees Hospital NHS Foundation Trust in such a sudden way. Frustrating because the recruitment and staffing issues underlying this unwelcome change have been known about for a long time.

“Indeed, I have been pressing the trust on this specific issue for well over a year, following a meeting I organised with local medical staff in 2017 to discuss recruitment in detail.”

The Mp said the trust have said they made the decision because they believe it is the only way to secure patient safety.

“As a layperson, it is difficult for me to argue they are wrong, and indeed our local GPs and medical staff appear to be supportive of the trust’s decision,” he added.

“What is clear is that the issue here is not money, but persuading a handful of relevant critical care and anaesthesia doctors to work at the Friarage.”

Mr Sunak that hollowing his representations, the trust agreed to review and improve its recruitment procedures, including widening its net to seek talent from overseas.

The MP also identified a specialist doctor recruitment agency to help and suggested the trust used incentives to encourage doctors based at the James Cook University Hospital in Middlesbrough to cover the Friarage rotas.

“It is clear that these efforts have not yielded sufficient results.

“There is a larger pool of critical care doctors at the James Cook who have been informally helping the Friarage for the past few months.

“As many of you have suggested to me, I have consistently pushed the trust to find ways to share these doctors permanently across both the James Cook and Friarage sites, given that they are part of the same trust.

“I have been told that the doctors have been offered substantial incentives to work at the Friarage permanently but have chosen not to accept. I have also been told that there is no way the trust can contractually roster these doctors to work permanently across both sites.”

According to the MP, one of the reasons James Cook doctors were not willing or not able to work at the Friarage was due to changes in clinical guidance from the Royal College of Emergency Medicine which requires more specialist emergency care consultants to work in critical care wards.

He said that historically, the Friarage has been staffed with more generalist consultants who are now retiring. There is a large pool of these generalist anaesthesia consultants at the James Cook but it is hard to persuade them to cover critical care at the Friarage as they feel that should be done by specialists, given the evolution of medical training and guidance from their Royal College.

The MP said that specialist critical care doctors preferred to work at larger hospitals like the James Cook where there was much higher activity in their chosen specialty compared to the very low volumes of this kind of work at the Friarage.

He added: “Obviously, my priority is to find a way to maintain our current A&E provision. But as I hope I have clearly explained, there is no easy way to do this, nor is it within my control and the issue is not simply one of financial resources.

“To solve this problem sustainably, the trust needs to find or persuade a handful of extra critical care doctors to permanently work at the Friarage – the funds are there to pay them if they are willing to work here, but the local medical community believes it will not be possible to adequately and sustainably staff the critical care unit for the reasons outlined above.

“My understanding based on information supplied by the Trust is that even with the proposed temporary changes, around 9 out of 10 patients who currently use emergency services at the Friarage will still be able to do so.”

The MP said that if the temporary arrangements did become permanent, there were several specific areas where he will concentrate his efforts:

He said: “I will be arguing for as much additional work to be done at the Friarage as possible. For example, I am pushing for more planned surgery (like short stay and day surgery cases) and outpatient appointments to be carried out at the Friarage, saving many of you a trip to the James Cook for these visits or a shorter wait for your appointment.

“I would want the 24/7 urgent treatment centre to treat ill children as well as adults as the current A&E does not cater for the full range of sick children. I know this is something many young families would welcome.

“I have successfully persuaded the trust to make the urgent treatment centre service available 24/7 rather than for only 12 hours, which is what they originally had planned. I will fight for 24/7 access to be maintained if these temporary arrangements become permanent.

“I shall also press for patients who may have to be admitted to the James Cook hospital at a critical stage in their treatment to be returned to the Friarage if they require a longer stay in hospital.

“I am talking to the Yorkshire Ambulance Service about issues around the safe transport of critically-ill patients to the James Cook from the more remote parts of the constituency, like the Dales.

“I shall be doing my best to support the staff affected by the changes. I have been assured by the trust that there are no planned redundancies and that the staff – mainly critical care nurses – who may be asked to transfer to James Cook will have their terms and conditions protected. They could also be compensated for the move by the trust. For those nurses for whom such a move is not practical or desirable, I am exploring ways they could receive any training required to remain at the Friarage in a different capacity.

The MP said he would continue to fight for an outcome which ensured a “sustainable future for our much-loved local hospital”.

“While I am not a medical professional, the NHS is in my blood. Both my parents dedicated their working lives to the health service and I am completely committed to ensuring your family can rely on the best possible hospital services locally,” he added.

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