Department of Health and Social Care
Central Government
Action Taken
NHS England (NHSE) is committed to finding ways to make awareness of the potential for sepsis, and the response to it, ever more consistent. The department has seen improvement in A&E waiting times this year following the Delivery Plan’s publication. (AI summary)
View full response
Dear Ms Mutch,
Thank you for your letter of 4 November 2022 to the Secretary of State for Health and Social Care Steve Barclay, about the death of Philip Day. I am replying as Minister with responsibility for urgent and emergency care. Please accept my sincere apologies for the significant delay in responding to this matter. I would like to assure you that the department is mindful of the statutory responsibilities in relation to prevention of future deaths reports and we are prioritising responses as a matter of urgency.
Firstly, I would like to say how deeply sorry I was to read the circumstances of Mr Day’s death and I offer my sincere condolences to his family. I am grateful to you for bringing these matters to my attention.
Your report raises concerns about to the treatment provided at Stepping Hill Hospital, Stockport NHS Foundation Trust. In preparing this response, my officials have made enquiries with NHS England (NHSE), local NHS services, and the Care Quality Commission (CQC).
In relation to the concerns about the identification and early treatment of sepsis, NHSE is committed to finding ways to make awareness of the potential for sepsis, and the response to it, ever more consistent. The Academy of Medical Royal Colleges (AoMRC) has also issued advice to support decision making on the appropriate treatment of Sepsis. The AoMRC statement sets out that there is any clinical concern or laboratory evidence, such as blood tests, it encourages escalation regardless of the patient’s NEWS2 score. This is already reinforced in medical and nurse training widely, but the consistency of application in practice is key. NEWS2 is primarily for use in a hospital setting, and the need for an equivalent process in the community is recognised, and consideration of this is being taken forward.
In relation to the concerns raised around the pressures in the emergency department and A&E waiting times, NHSE inform me that the local plan in place within Greater Manchester to help address A&E waiting times, includes upscaling primary care, increasing the number of 111 and 999 call handlers, improving the use of the directory of services and navigation of alternatives to A&E, and to provide better home support to help reduce pressure on hospital bed capacity and enable faster patient flow through hospitals. Locally work is underway to create a shared care record across primary and secondary care meaning pathology results will be able to be viewed along with clinical reviews whether undertaken in a community or hospital setting. I have asked officials to further raise the processes for information sharing between community out-of-hours services and emergency departments, with NHS England
The CQC has also considered your report and will continue to monitor waiting times in emergency departments, delayed admissions and waiting times for surgery with regular trust engagement on ongoing risks and pressures.
I recognise the pressures our A&E services are facing and the impact on waiting times for patients. That is why we published our 2-year Delivery plan for recovering urgent and emergency care services in January 2023, which aims to deliver sustained improvements in emergency waiting times. The ambition is to improve A&E wait times to 78% of patients being admitted, transferred, or discharged within four hours by March 2025. A key part of the plan has been to increase hospital capacity to improve patient flow and reduce overcrowding in A&E. We have achieved the ambition of delivering 5,000 more staffed, permanent beds this year compared to 2022-23 plans - backed by £1 billion of dedicated funding. Further, we also achieved our target of scaling up virtual ward beds to over 10,000 in advance of winter.
We recognise that a whole-system approach is needed to ensure people get the emergency care they need when they need it. This is why we have made £1.6 billion of funding available over two years to support the NHS and local authorities to ensure timely and effective discharge from hospital, helping to free up beds and reduce long waits for admission from A&E.
We have seen improvement in A&E waiting times this year following the Delivery Plan’s publication. National A&E 4-hour performance improved by 3.3ppt to 74.2% in March 2024 from 70.9% in February 2024, and up from 71.5% in March 2023. However we recognise there is more to do, and reducing waiting times is a priority for this Government.
Thank you once again for bringing these concerns to my attention.
Yours,
HELEN WHATELY
Thank you for your letter of 4 November 2022 to the Secretary of State for Health and Social Care Steve Barclay, about the death of Philip Day. I am replying as Minister with responsibility for urgent and emergency care. Please accept my sincere apologies for the significant delay in responding to this matter. I would like to assure you that the department is mindful of the statutory responsibilities in relation to prevention of future deaths reports and we are prioritising responses as a matter of urgency.
Firstly, I would like to say how deeply sorry I was to read the circumstances of Mr Day’s death and I offer my sincere condolences to his family. I am grateful to you for bringing these matters to my attention.
Your report raises concerns about to the treatment provided at Stepping Hill Hospital, Stockport NHS Foundation Trust. In preparing this response, my officials have made enquiries with NHS England (NHSE), local NHS services, and the Care Quality Commission (CQC).
In relation to the concerns about the identification and early treatment of sepsis, NHSE is committed to finding ways to make awareness of the potential for sepsis, and the response to it, ever more consistent. The Academy of Medical Royal Colleges (AoMRC) has also issued advice to support decision making on the appropriate treatment of Sepsis. The AoMRC statement sets out that there is any clinical concern or laboratory evidence, such as blood tests, it encourages escalation regardless of the patient’s NEWS2 score. This is already reinforced in medical and nurse training widely, but the consistency of application in practice is key. NEWS2 is primarily for use in a hospital setting, and the need for an equivalent process in the community is recognised, and consideration of this is being taken forward.
In relation to the concerns raised around the pressures in the emergency department and A&E waiting times, NHSE inform me that the local plan in place within Greater Manchester to help address A&E waiting times, includes upscaling primary care, increasing the number of 111 and 999 call handlers, improving the use of the directory of services and navigation of alternatives to A&E, and to provide better home support to help reduce pressure on hospital bed capacity and enable faster patient flow through hospitals. Locally work is underway to create a shared care record across primary and secondary care meaning pathology results will be able to be viewed along with clinical reviews whether undertaken in a community or hospital setting. I have asked officials to further raise the processes for information sharing between community out-of-hours services and emergency departments, with NHS England
The CQC has also considered your report and will continue to monitor waiting times in emergency departments, delayed admissions and waiting times for surgery with regular trust engagement on ongoing risks and pressures.
I recognise the pressures our A&E services are facing and the impact on waiting times for patients. That is why we published our 2-year Delivery plan for recovering urgent and emergency care services in January 2023, which aims to deliver sustained improvements in emergency waiting times. The ambition is to improve A&E wait times to 78% of patients being admitted, transferred, or discharged within four hours by March 2025. A key part of the plan has been to increase hospital capacity to improve patient flow and reduce overcrowding in A&E. We have achieved the ambition of delivering 5,000 more staffed, permanent beds this year compared to 2022-23 plans - backed by £1 billion of dedicated funding. Further, we also achieved our target of scaling up virtual ward beds to over 10,000 in advance of winter.
We recognise that a whole-system approach is needed to ensure people get the emergency care they need when they need it. This is why we have made £1.6 billion of funding available over two years to support the NHS and local authorities to ensure timely and effective discharge from hospital, helping to free up beds and reduce long waits for admission from A&E.
We have seen improvement in A&E waiting times this year following the Delivery Plan’s publication. National A&E 4-hour performance improved by 3.3ppt to 74.2% in March 2024 from 70.9% in February 2024, and up from 71.5% in March 2023. However we recognise there is more to do, and reducing waiting times is a priority for this Government.
Thank you once again for bringing these concerns to my attention.
Yours,
HELEN WHATELY