Daily Insight: The heat is on

It’s been almost two months since West Midlands Ambulance Service’s nursing director Mark Docherty predicted the exact date his organisation may “fail”.

And if the latest data is anything to go by, the trust is indeed heading into its most pressurised period yet.

Serious incidents causing patient harm at WMAS have tripled in the first three months of this year, compared with 2019, according to figures shared with HSJ.

It follows a week of intense pressure at the country’s ambulance services, with handover delays a particular issue as covid soars and the weather heats up. An acute chief in the Midlands described Monday night into Tuesday as the “worst night ever”, a sentiment echoed by Mr Docherty, who revealed his service had 700 patients in a stack on Monday.

Mr Docherty explained how the harm incidents, including deaths, resulted from growing delays: ”You can’t underplay the risk. If you’ve got 750 patients like we did on Monday waiting, none of those patients have been assessed.

“Sadly, amongst them there will have been patients with stroke who won’t be treated because they’ve waited too long.

“There will be some patients that probably die, because that’s the nature of emergency work.”

A temporary problem

A trust is considering a ban on the use of agency staff in its corporate directorate following a £6m spend on temporary workers in that division.

South London and Maudsley Foundation Trust shelled out the money after admin cuts left its HR department underpowered. It also overpaid staff from the trust as a whole by more than £1.1m in 2021-22, it said, with an estimated £300,000 so far this year. Its annual wage bill is £234m.

The mental health trust said the overpayments were a mixture of wages paid to staff who accepted a job offer and then did not take it up, plus staff who left but then continued to be paid. It is not known how much of the overspend will be written off, rather than successfully reclaimed.

Like many trusts, SLAM has to spend a lot on agency staff to fill gaps in its nursing and medical workforce but last financial year its spend on agency staff in its corporate division – ie teams not directly providing clinical services – was £6m.

A report to the trust’s board said the root causes were “minimal accountability for managers not processing [the] leavers form promptly” and “limited HR capacity”.

HSJ understands the trust’s administrative staff were cut back in efficiency programmes over recent years.