Overnight access to the Accident & Emergency department at West Cumberland Hospital is potentially under threat.
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In a story in the Whitehaven News, a spokesperson for North Cumbria Integrated Care NHS Foundation Trust admitted that “there is a risk that we may be unable to provide appropriate overnight cover in the future” due to the lack of emergency doctors.
This could leave patients in West Cumbria forced to travel an hour to the nearest A&E at Cumberland Infirmary in Carlisle in the middle of the night.
I am wholly opposed to any suggestion that we lose a fully-staffed, fully operational 24/7 A&E department capable of dealing with emergency patients at any hour of the day or night. The government need to step up to stop us losing any part of this vital service in West Cumbria.
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Details of the campaign so far can be found below. I’ll keep this page updated as the campaign progresses.
8th August – letter to the CEO of North Cumbria Integrated Care NHS Foundation Trust
I wrote to the Chief Executive of the trust to demand urgent answers to my questions about reports that our A&E is struggling to maintain an overnight service.
9th August – response to my letter from the CEO
“We recognise that the people of west Cumbria need access to safe emergency care and we are working very hard to maintain services in the face of potential temporary staffing shortages. The good news is that we have recently successfully recruited two more permanent consultants to our A&E team – one has recently joined us and the other will join us in September. While we do still have some gaps, which we cover with agency locum and bank doctors, we are in the best position we have been in for some time. In the longer term, we have strategies to train more clinical staff to a higher level in line with the Royal College of Emergency Medicine’s medical workforce guidelines for small and rural emergency departments. We also attend recruitment fairs having recently been in both London and Glasgow.
“However, it is true to say that recruiting middle and senior emergency clinicians to work in west Cumbria is challenging, which means at times our workforce is stretched. As you would expect, we have business continuity plans in place for this and a range of scenarios across the Trust to enable us to continue to provide safe services for patients at all times. The A&E business continuity plan for WCH was developed with our clinical teams last year to ensure we can continue to provide a safe service in the department should a staffing issue arise with regard to middle grade doctors covering the overnight rota. To date, we have not needed to enact this plan, however should we need to do so, we would proactively inform our partners and the public and explain what this would mean in practical terms.
“The plan details the contingency arrangements for the overnight rota. If the plan was implemented, the A&E department would remain open at all times and if someone walked into the department between those hours, they would be assessed and a decision made about the best course of action for their safe care or treatment. This may involve being directly referred to another department at WCH, or being transferred to the Cumberland Infirmary in Carlisle (CIC). For someone arriving via ambulance, our colleagues at North West Ambulance Service have been involved in the continuity plans and we would discuss the best course of action on a case-by-case basis. There would be an on-call consultant who could be contacted in an emergency as well as on-call consultants for other areas as normal such as paediatrics and surgery. The department would also plan to increase senior nursing cover during those shifts.”
The response suggests that there is a chance of the withdrawal of overnight A&E services, in all but name. The contingency plan is to keep the doors open but – in the case of a lack of senior medical personnel – send some patients to the Cumberland Infirmary who might otherwise be treated in A&E during business as usual. This is not the level of service local people expect and it would not meet any reasonable definition of a 24 hr A&E department.
I know that the trust are doing everything they can to recruit staff and keep a fully functioning A&E at West Cumberland. They’re being forced to make extremely difficult decisions about services because the government failed to provide an NHS workforce plan for more than a decade. The government’s mismanagement is having very real consequences for the quality of health and social care for people in West Cumbria.
10th August – public meeting on the future of emergency care in West Cumbria
I organised a public meeting to discuss the issue with Wes Streeting MP, Labour’s Shadow Secretary of State for Health and Social Care, and Mahesh Dhebar of the ‘We need West Cumberland Hospital’ campaign group on 10th August.
See coverage of the meeting in the Whitehaven News
10th August – visit to University of Cumbria
I joined Labour’s Parliamentary candidate for Carlisle, Julie Minns, on a visit to the University of Cumbria to learn more about their partnership with Imperial College London which will train 50 doctors here, from Cumbria, for Cumbria.
Read coverage of the visit in the News & Star
This is a great start but doesn’t go far enough, but there is a government cap on the number of medical school places. Wes Streeting confirmed Labour’s plan to double the numbers and I’ll be pushing to deliver this and make sure that West Cumbria benefits from this.
6th September – follow up letter to the CEO of North Cumbria NHS Integrated Care Foundation Trust
This week I wrote a follow up letter to Lyn Simpson relaying the concerns raised by patients and staff members at our public meeting over the summer.
15th September – meeting with the Chair of North Cumbria NHS Integrated Care Foundation Trust
This week I received a response to my above letter from the CEO, thanking us for our support of the hospital and agreeing that our proposal for more board and governor meetings in West Cumbria is a sensible one that they’ll look into.
Today I met with the Chair of the trust to discuss emergency care. It was a productive discussion and I hope the first of many. I want to work with the trust on this and secure the future of a 24/7 A&E at West Cumberland Hospital.
I’ll be visiting the hospital in the coming weeks and meeting with the trust leadership to discuss this issue in more detail and support their efforts to recruit more doctors to work in West Cumbria.
I’ll keep this page updated as the campaign progresses.
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Josh MacAlister MP 