UK cancer and children’s wards being hit by closures

NHS staffing crisis is forcing patients to travel long distances for treatment as services are centralised

Growing numbers of hospital units that provide cancer care and children’s services are among those being forced to shut because the NHS’s deepening staffing crisis means it has too few doctors and nurses to operate them safely.

The closures are leading to patients having to travel further to receive care as NHS bosses increasingly decide to centralise services in fewer hospitals in response to gaps in rotas.

The trend prompted the Royal College of Nursing (RCN) to warn that “skeleton staffing” means patients are suffering.

“Every day brings fresh and devastating examples of patients paying the highest price for staffing shortage. There are no benefits to running the NHS on a skeleton staff and refusing to acknowledge that means the ultimate losers, as ward closures around England show, are patients,” said Dame Donna Kinnair, the RCN’s acting chief executive.

Units providing cancer care, services to children and rehabilitation to older patients are among those affected by an ongoing trend which critics say is slimming-down by stealth of NHS care.

Patients with cancer who would usually have surgery at the Queen Elizabeth hospital (QEH) in King’s Lynn, Norfolk, could face 80-mile round trips after the trust that runs the QEH said it was considering closing one ward and moving cancer surgery to Norwich, because it has tried and failed to attract enough nurses to work there.

Sir Henry Bellingham, the Conservative MP for north-west Norfolk, said the move “would be an admission of defeat on the part of the QEH and would seriously damage morale”.

Peter Passingham, a regional organiser with the union Unison, said the switch of services would be “a body blow”. The plan sparked a protest in King’s Lynn on Saturday.

In an internal QEH memo leaked to the Eastern Daily Press newspaper, senior trust staff said: “We currently face a situation where, despite the decision the board took in September to flexibly close 12 medical and 12 elective surgical beds, we do not anticipate having the capacity to continue with our elective programme throughout the winter. This includes our elective cancer programme.

“This situation has largely arisen because [the] number of nurses we have been able to recruit into substantive posts has been less than expected. For reasons of quality and safety [of care] the executive team do not want to take any decisions which dilute staffing levels to a position where they include a greater number of agency staff than is absolutely necessary.”

Wolverhampton’s New Cross hospital is gearing up to start receiving extra patients as soon as the A&E unit at Princess Royal Hospital in Telford starts closing overnight in December. The move has been prompted by the inability of the trust that runs the Telford unit to hire enough doctors and nurses to staff it safely.

Kinnair said: “Staffing shortages push nursing staff to the limit, forcing them to deal with intolerable pressure and escalating workloads. Wards across the country find themselves in a position where even one or two registered nurses leaving or retiring means there’s no conceivable way to operate safely, and the remaining workforce are uprooted to plug gaps in rotas elsewhere.”

Dr Rob Harwood, chair of the British Medical Association’s consultants committee, said: “The NHS is already chronically understaffed, and this is inevitably impacting upon hospitals and their ability to adequately staff departments and services. If a hospital can’t fill rotas because they don’t have the staff, then services are eventually bound to be compromised and patient care will suffer.

“Patients expect to be able to be treated at a hospital local to them, not to have to travel many miles at what may already be a stressful time for them, but that may not always be possible if hospitals have too few staff.”

The BMA has warned that Brexit will make NHS understaffing even worse if fewer doctors from the EU27 countries decide to come and work in Britain.

Dorset HealthCare NHS trust is phasing out the 16-bed Saxon ward at Wareham community hospital because of a lack of nurses. “Everything has been done to try and secure the qualified nurses to run the ward safely but, unfortunately, that has not been possible,” said Ron Shields, the trust’s chief executive. None of the nurses affected by the closure will be made redundant, however, because the trust has so many other vacancies it needs to fill.

The planned closure of a 24-bed rehabilitation ward at Bishop Auckland hospital in County Durham has been put on hold after staff, councillors and the local MP criticised the move. Ward six, which provides “step-down” care for patients waiting to go home, was due to shut at the end of October.

County Durham and Darlington NHS foundation trust planned to redeploy the staff to fill vacancies in other hospitals it runs. The trust’s executive director of operations, Carole Langrick, last week apologised for its push to close the ward “causing an unnecessary level of concern”.

In Scotland, almost 1,000 children have had to be transferred to the Royal Hospital for Sick Children in Edinburgh from St John’s hospital in Livingston, west Lothian, since its children’s inpatient ward closed in July 2017 as a result of staffing problems. Four in five of the under-18s has been admitted to the hospital in Scotland’s capital.

Jeane Freeman, the health secretary in the Scottish government, has pledged to reopen the ward. Critics claim that the “utterly unacceptable” situation is forcing families from west Lothian to make round trips of up to 60 miles to visit their children.

Earlier this month, the Guardian revealed that cancer patients would no longer be able to have chemotherapy at King George hospital in Ilford, Essex, because its parent trust had too few specialist cancer nurses.

A Department of Health and Social Care spokesperson said: “There are 11,900 more nurses on our wards since 2010 and we are committed to ensuring our record numbers of dedicated staff get the support they need to deliver excellent, safe care for patients.

“Changes to local NHS services are agreed locally, and in every case the priority is ensuring patients can receive best possible care.

“To ensure the right staff are in the right places, workforce planning will be at the heart of the NHS long-term plan, which is backed by £20.5bn a year to support our drive to expand the medical, nursing and midwifery workforces.”


Denis Campbell Health policy editor

The GuardianTramp

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