Daily Insight: A long, cold summer

England may be experiencing an extremely hot July, but this hasn’t stopped winter-style pressures from continuing to cause trouble in the NHS.

According to multiple NHS leaders they are having to balance risks and make “horrible” decisions about whether to care for patients in corridors or hold up ambulances, which are unable to hand over patients safely.

This has been described as the other side of the ambulance crisis, and according to NHS leaders, one that has been given less airtime than ambulance waits but is equally as dangerous.

It is understood corridor care is now referred to as “cohorting”, but without the proper staffing still carries the same patient safety concerns, with trusts telling HSJ they have resisted it.

There has been mounting tension between acute trusts and ambulance services over recent months and there have been calls to work together and “avoid blaming each other”, according to HSJ readers.

It is widely acknowledged the problem lies with poor flow through the accident and emergency department and acute trusts being unable to discharge patients due to constraints in community and social care.

With this debate raging over the summer, the winter feels very foreboding indeed.

Surrey’s steep learning curve

Problems with the launch of an electronic patient record at two hospitals prompted a visit from NHS England director of transformation Tim Ferris with the aim of “learning lessons” for future rollouts.

Mr Ferris and NHSE regional team and integrated care board managers visited the Royal Surrey Foundation Trust on 1 July, according to the ICB.

A report to the Surrey Heartlands Integrated Care Board meeting last week revealed there had been “significant difficulties”, particularly in outpatients, with the “Surrey Safe Care” system – supplied by Cerner — that went live in mid-May at the Royal Surrey FT and Ashford and St Peter’s Hospitals FT.

The meeting heard of problems including with the booking and administration of outpatients and elements of following up patients; delays to some outpatient appointments; A&E four-hour waits and ambulance handover being made worse; and the two trusts having to validate data on each patient moved to the new system to “ensure that nothing has been missed”. 

HSJ asked the two trusts for details of how many patients had been affected but instead was given a single response from the two trusts and Surrey Heartlands integrated care system. 

It said: “Additional resources has also been secured to revalidate the clinical data entered since go-live to check it has been entered correctly and the correct follow-up activities are scheduled.

“That said, over the recent weeks we have encountered difficulties in booking in non-urgent outpatient appointments and as a system we are working hard to tackle this. We would like to thank patients for bearing with us and our staff for all their hard work in supporting adoption of the new system.”