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Trafford Hospital A & E Dept & Dependant Units - Statistics & Estimated Impact on Area

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Dear Central Manchester University Hospitals NHS Foundation Trust,

Please provide me with figures for the years 2011-12, 2012-to date, which show attendances at the Accident and Emergency department of Trafford General Hospital.

Please provide and explain any classifications for such attendances, including their ages, and the number of admissions which resulted.

Please provide details of staffing numbers in the A&E Trafford department and the dependant departments (Intensive Care Unit, Emergency Surgery, Paediatric and Observation Units) for the years 2011-12, 2012-to date.

Please provide details of how many patients treated in Accident and Emergency were later admitted to the Intensive Care Unit, Emergency Surgery, Paediatric and Observation Units at Trafford General Hospital, or who were subsequently transferred to other hospitals and which hospitals were they taken to.

Please provide the times taken to transfer these patients to the other hospitals and the availability of beds when they arrived at Trafford Hospital and the receiving hospital they were then sent to, and the wait they endured before they received their treatment.

With regards to the critical ‘golden hour’ (first hour) of treatment for emergency patients, could you please confirm the accuracy of the statement ‘For every 10 minutes a patient has to wait/travel there is a 20% decrease in life expectancy, i.e. for every 10 minutes = 20%, for 20 minutes = 40%, etc.?

Please provide me with the estimated death rate per year if the A&E closes at Trafford between 12.00 – 8.00 a.m. through travel to these other hospitals further afield.

Please provide me with the estimated death rate per year if the A&E closes as seems to be the intention through travel to these other hospitals bearing in mind the football traffic around three times a week from Manchester United, plus Manchester City, and the cricket and pop concerts at Lancashire Cricket Club, and other traffic realities like the many road works and other delays like rush hour twice a day that don’t seem to have been properly taken into account.

Have all the above scenarios been taken into account when calculating the death toll through travel time whilst sending the local population to these other hospitals further afield and please state each scenario taken into account?

With using the previous five years data please calculate the estimated amount of emergency patients in Trafford that would have died as result of not having an A&E department at Trafford having to go to other hospitals further afield with the realistic traffic delays previously touched on?

Please provide me with the estimated death rate per year if the A&E & Intensive Care Unit closes as may be the case through travel to these other hospitals.

Please provide me with the estimated death rate if the A&E, Intensive Care Unit and Emergency Surgery Units at Trafford General Hospital close as may be the case through travel to these other hospitals further afield.

Please provide me with the estimated death rate if the A&E, Intensive Care Unit and Emergency Surgery and Paediatric at Trafford General Hospital close as may be the case through travel to these other hospitals further afield.

Please provide me with the estimated death rate if the A&E, Intensive Care Unit and Emergency Surgery and Paediatric and Observation Units at Trafford General Hospital close as may be the case through travel to these other hospitals further afield.

With regards to the hospitals further afield who are earmarked to take the full weight of Trafford’s’ Accident and Emergency patients when it is closed already failing to meet their basic guidelines to meet their four hour waiting deadlines what impact do you think another 39.000 people that would usually use the Emergency & Accident from Trafford each year have on those hospitals, their already stretched waiting times and their patients?

(39,000 figure is the from a previous Information Request - Matt Finnegan - approximate average amount of people using Trafford A&E up to 2010)

Please provide me with a copy and/or access to all reports, minutes and other documents concerning the current and/or future provision of A & E services and the other dependant units stated above at Trafford General Hospital to show the full consideration and impact on Trafford and the surrounding areas the realities of these cuts will have on the lives of the locals who live there and those in the areas further afield who will also be impacted.

Thank you for your time, understanding and consideration.

Yours faithfully,

Neil A. Carter

foi (RW3) CM&MC Manchester, Central Manchester University Hospitals NHS Foundation Trust

2 Attachments

Dear Mr Carter

 

We are writing to acknowledge receipt on 6/8/13 of your request for
information under the Freedom of Information Act 2000.  Your request has
been assigned the following reference number FOI 303-13 and please could
you quote this reference number in any future correspondence relating to
your request.

 

We will endeavour to respond to your request within the statutory 20
working days time limit subject to the following constraints:-

 

(a) The Freedom of Information Act 2000 defines a number of exemptions,
which may prevent the release of the information you have requested. If
any of the exemption categories apply, the information will not be
released to you and we will advise you accordingly, including your rights
of appeal.

 

(b) If the information you have requested contains reference to a third
party, we will consult with them prior to making a decision on whether to
release the information to you.

 

Further information is also available from the Information Commissioner
at:-

 

Information Commissioner’s Office

Wycliffe House

Water Lane

Wilmslow

SK9 5AF

 

Telephone: 0303 123 1113

Website: [1]www.ico.org.uk

 

If you require any further information regarding your request, please do
not hesitate to contact us.

 

 

Nicholas Jones

Information Governance Manager

Central Manchester University Hospitals NHS Foundation Trust

Oxford Road, Manchester M13 9WL

Tel: 0161 701 0375

E-mail: [2][email address]

 

[3]www.cmft.nhs.uk  Central Manchester University Hospitals NHS Foundation
Trust includes: Manchester Royal Infirmary, Manchester Royal Eye Hospital,
Royal Manchester Children's Hospital, Saint Mary's Hospital, University
Dental Hospital of Manchester, Trafford Hospitals and Community Services.

 

[4]cid:image001.jpg@01CB7137.3AE53170[5]cid:image003.jpg@01CB7137.3AE53170cid:image003.jpg@01CB7137.3AE53170 

 

 

 

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Dear foi (RW3) CM&MC Manchester,

By law, your authority should have normally responded promptly to my freedom of information request and I certainly should have received a response from you before the legal deadline of 3rd September 2013.

Please explain the reason for your delay and inform me when your authority will be responding to my freedom of information request?

Yours sincerely,

Neil A. Carter

Taylor Cara-Frances (RW3) CMFT Manchester, Central Manchester University Hospitals NHS Foundation Trust

I have now left CMFT.

Please forward your email to [Central Manchester University Hospitals NHS Foundation Trust request email].

Data Protection Policies and Procedures can be found on the intranet in the Departments section under the heading 'Information Services'.

Freedom of Information queries should be sent to [email address].

Kind regards,

Cara Taylor

Privacy and Confidentiality Notice: The information contained in this e-mail is intended for the named recipient(s) only. It may contain privileged and confidential information. If you are not an intended recipient, you must not copy, distribute or take any action in reliance on it. If you have received this e-mail in error, we would be grateful if you would notify us immediately. Thank you for your assistance.

Please note that e-mails sent or received by our staff may be disclosed under the Freedom of Information Act (unless exempt).

foi (RW3) CM&MC Manchester, Central Manchester University Hospitals NHS Foundation Trust

Dear Mr Carter,

Thank you for your email and I apologise that on this occasion we have not responded within the twenty working day time limit. Your request is currently being processed, the relevant data has been collected and a response is being finalised.

Kind regards

Nicholas Jones
Information Governance Manager
Central Manchester University Hospitals NHS Foundation Trust
Oxford Road, Manchester M13 9WL
Tel: 0161 701 0375
E-mail: [email address]

www.cmft.nhs.uk Central Manchester University Hospitals NHS Foundation Trust includes: Manchester Royal Infirmary, Manchester Royal Eye Hospital, Royal Manchester Children's Hospital, Saint Mary's Hospital, University Dental Hospital of Manchester, Trafford Hospitals and Community Services.

 

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Dear Nicholas,

Thank you for your reply.

Could you please inform me how many more days you estimate it will take to finalise and deliver this delayed FOI request?

Thank you for your time.

Yours sincerely,

Neil A. Carter

foi (RW3) CM&MC Manchester, Central Manchester University Hospitals NHS Foundation Trust

3 Attachments

Dear Mr Carter,

 

Please see the attached response to your request for information.

 

Yours sincerely

 

Nicholas Jones

Information Governance Manager

Central Manchester University Hospitals NHS Foundation Trust

Oxford Road, Manchester M13 9WL

Tel: 0161 701 0375

E-mail: [email address]

 

[1]www.cmft.nhs.uk  Central Manchester University Hospitals NHS Foundation
Trust includes: Manchester Royal Infirmary, Manchester Royal Eye Hospital,
Royal Manchester Children's Hospital, Saint Mary's Hospital, University
Dental Hospital of Manchester, Trafford Hospitals and Community Services.

 

[2]cid:image001.jpg@01CB7137.3AE53170[3]cid:image003.jpg@01CB7137.3AE53170cid:image003.jpg@01CB7137.3AE53170 

 

Privacy and Confidentiality Notice: The information contained in this
e-mail is intended for the named recipient(s) only. It may contain
privileged and confidential information. If you are not an intended
recipient, you must not copy, distribute or take any action in reliance on
it. If you have received this e-mail in error, we would be grateful if you
would notify us immediately. Thank you for your assistance.

Please note that e-mails sent or received by our staff may be disclosed
under the Freedom of Information Act (unless exempt).

References

Visible links
1. http://www.cmft.nhs.uk/

Dear foi (RW3) CM&MC Manchester,

Dear Nicholas,

Thank you for your reply.

1. According the prospectus discussed at the town hall council meeting where every political party voted with cross party consensus against the closure of Trafford A&E the information given was that you intend to reduce the current services to the local community from Trafford NHS even further than the next instalment of cuts due soon to leave it without A&E services overnight to the total closure of the A&E departments and its’ reliant departments – Is this true, and if this longer term intention is true then why are you trying to portray that you only intend cutting the services overnight and that is the total extent of any intended closures?

With regards to the ‘Golden Hour’ I understand 50 minutes delay does not necessarily translate to 100% death rates but the basic principle of the first golden hour of attention and treatment is crucial to the possible outcome of a critical patient.

2. Do you, or, do you not agree that the best possible outcomes for critical patients are if they are seen to as fast as possible by trained medical staff and given immediate access to accident and emergency services as soon as possible to prevent fatalities and reduce negative outcomes?

3. Given the principle of the faster the better, is it not true that the time it would take for a critical patient in the Trafford area to get this crucial service would increase proportionately depending on which hospital they were taken?

4. Therefore, is it not true that given the same critical patient, any additional time delays in them getting the crucial treatment they need would inherently mean there is an increased chance of death or of a negative outcome?

Unfortunately, me and many other Trafford residents whose lives depend on these local Trafford NHS A&E services which are central to their very existence do not believe that closing their nearest Accident & Emergency department will actually benefit them personally as they and their families will have no choice but to wait longer and receive treatment later having no option but to travel longer distances further afield through additional traffic chaos to get to these same services in the areas of those other hospitals you mentioned.

It is inherent that these people who rely on Trafford A&E will lose out if it shuts and their lives will be put in more danger as a direct result!

It staggers me how professionals responsible for the health of this area who work in this field of saving lives cannot admit this basic fact and seem to endeavour to spin it otherwise?!

The brutal truth of the matter is this closure cuts the monies used at Trafford A&E and its dependant departments which will then be used in other hospitals in areas further afield and therefore is directly detrimental to the wellbeing of these Trafford residents affected – Which is contrary to the responses you have tried to portray that it has been done to help those in that area.

5. How can it help them if the significant delays in their individual treatment inherently puts theirs lives in more danger through longer travel delays to eventually get this emergency treatment?!!!

Trafford residents would argue that for them to receive the most effective clinical care would be to have those essential services as close as possible to them so there is the least delay in their treatment if they were to be in a critical condition – So, the truth of the matter for them would be they would receive the most effective clinical care for them by moving some more of these professionals and their equipment into this area – Not by closing it!

The previous NHS closures of these essential A&E services have already demonstrated an increase in fatalities across the country such as Newark hospital.

6. Are you familiar with Prof Jon Nichol and his research at Sheffield University and his and many other reported senior doctors’ conclusions that mortality rates will increase with longer ambulance journeys?

At present, I understand there are ambulance stations dotted all round the area. The accident and emergency process for an emergency call out for an ambulance could mean them coming from the base where it is parked up, from a hospital or on route.

7. If Trafford A&E is closed where would the ambulances go and how would they be used for the local residents?

The ambulance has to leave where it is when it is called upon and has to travel to the accident victim, see to their needs and transfer them to the accident and emergency if necessary, unload and report for their next duty. This all takes time and the longer the journey the longer the time it is not able to be used for other emergencies especially if there are traffic problems which are considerable at times.

If an ambulance has to travel further afield to transfer emergency patients (which it will have to do for local residents if Trafford A&E closes) then that ambulance cannot see to other patients at the same time so will that also mean even longer times for patients waiting for them to turn up as they can’t be in the same place at the same time, and they may well be a considerable distance away from the next critical patient awaiting life saving procedures.

8. Are you planning on increasing the number of ambulances and staff for these ambulances to these areas to make up for this inherent shortfall in availability?

The types of ambulances available should also be considered as I understand that the St John’s ambulances do not have the facilities and capabilities of the other ambulances used. These others may be safe but the question of timely has to be properly considered as this is inherently extended by the additional necessary travel.

9. Will the vast majority of the people of Trafford who are in a critical condition have to travel further than their current situation allows and is it inherent that this will in general mean longer travel times, and thus could it not be construed that the mortality rates for some of these people will be increased significantly and would not be an improvement of their care?

How can it be better for the Trafford residents if it takes longer for the ambulance to get to them and take them to a hospital A&E which is further away as this will inherently take a significant amount longer which will invariably increase their risks and possible outcomes?!

The least I would expect from a professional life saving body such as yours who should have all taken the Hippocratic Oath is that when making the critical decisions on which area has more chances of living or dying they would be able to carry out the proper research into this decisive matter - Before endorsing any closures!

10. Yet, in your response you seem to state that no research whatsoever has been undertook into the possible after effects of this historic closure and even worse, you state there is no intention of doing any in the future?!!!

It’s incredulous to think our lives seem to be held in such precarious hands and those responsible do not seem to have the insight or the common sense to try to calculate the possibilities using the figures available to them or could be gained with some basic research!

The additional times taken to travel are not insignificant if you are in a critical condition and these additional delays in treatment for those suffering with a stroke or have had a heart attack could well have a massive impact on their lives leaving them dead or in further severe ill health for their futures and their families futures.

11. Whilst I can appreciate specialist units in specific hospitals to cover their surrounding areas could be beneficial would it not be an improved system with better outcomes for Trafford residents for each A&E department to have some specialists who could limit the negative outcomes quickly and then pass the patient on to these specialist units for additional treatment later?

With regards to the recently published medical report findings I have learnt to be very wary of this government offering statistics to back up an argument having witnessed many previous examples of their spin opposite to the actual truth at heart of the matter and the repeated omissions to the argument which are kept hidden that actually counter the direction they intend to proceed no matter what!

I’m wary that this could be a scenario of if you don’t want to know the answer to a question – Then don’t ask the question?!

12. What measures have been put in place to prevent you from asking the ambulance drivers and actually testing how long it takes them to go to each of these other hospitals mentioned who would have to be relied upon to take up the Trafford A&E casualties when it is closed, using a blue light at different times of the day to take into full consideration the traffic chaos previously mentioned that is present at match times and rush hours, etc.?

A quick check on a SatNav will give you an accurate distance for each possible route from those outlying areas affected and their estimated travel times from and to all those hospitals mentioned which will have to take up these patients from Trafford. What measures have been put in place to prevent you from accurately researching this properly so a more qualified conclusion could be reached?

Given that travel time from and to Trafford NHS A&E is a necessity at the moment for those using the Trafford A&E facilities I think that would be a fair base line to use to calculate from there to compare the difference to when it is to be closed.

i.e. any additional travel time from that hospital they would usually rely on for their health (Trafford) to go to each of the other hospitals (Wythenshawe, Hope, Manchester Royal Infirmary and possibly Withington) should suffice to quantify the difference in travel times and thus properly evaluate the additional dangers inherent to this closure.

13. Using the previous 5 years figures and descriptions of usage please estimate the possible fatalities and negative outcomes given the additional averaged timings in travel to and from each receiving hospital from the more thorough research undertook to more accurately predict the future outcomes for the local Trafford residents from the closure of this essential NHS A&E service?

14. According to the information given at the town hall meeting these hospitals were not meeting the maximum four hour waiting time criteria expected in A&E departments so I can only presume there have been improvements since for you to state they are all meeting these guidelines now?

15. Given the recent report that 20% of NHS funding is not going towards patient care but is going on insurance and NHS legal defence costs would it be incumbent on you to do the proper research so you are not opening yourselves up to even more legal challenges in the future from those families whose lives have been devastated because of the additional delays in them or their loved ones receiving their proper emergency care due to the closure of their nearest A&E department?

I strongly suggest you stop forthwith the intended closure of Trafford A&E department and implement proper due process to thoroughly research the various possible outcomes properly before attempting this possible closure in the future to fully take into account the local Trafford residents and their future health issues who will be adversely affected by this historical decision.

Thank you for your time, understanding and I trust the further consideration necessary to fully understand the possible outcomes for the Trafford residents adversely affected and the surrounding areas this critical decision will impact upon.

Yours sincerely,

Neil A. Carter

FOI (RW3) CMFT Manchester, Central Manchester University Hospitals NHS Foundation Trust

1 Attachment

Dear Mr Carter,

 

We are writing to acknowledge receipt today Wednesday 27/11/13 of your
request for an internal review and additional information in response to
our reply to your Freedom of Information request, FOI 303-13 refers. This
has been passed to our line manager Gareth Summerfield, Head of
Information for his consideration and a response.

 

Please note that Nicholas Jones has now left the Trust.

 

Kind regards

 

Gio

 

Giovanni Cerisola

Information Governance Manager

 

Central Manchester University Hospitals NHS Foundation Trust

Room 341, 3^rd Floor, Cobbett House

Manchester Royal Infirmary, Oxford Road

Manchester, M13 9WL

Tel: 0161 701 0375

Email: gio.cerisola[1]@cmft.nhs.uk

 

[2]www.cmft.nhs.uk  Central Manchester University Hospitals NHS Foundation
Trust includes: Manchester Royal Infirmary, Manchester Royal Eye Hospital,
Royal Manchester Children's Hospital, Saint Mary's Hospital, University
Dental Hospital of Manchester, Trafford Hospitals and Community Services.

 

[3]Brand StripeBrand Stripe

 

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FOI (RW3) CMFT Manchester, Central Manchester University Hospitals NHS Foundation Trust

5 Attachments

Dear Mr Carter,

 

Please find attached our formal response to your request for an internal
review of our response to your recent Freedom of Information request,
reference FOI 303-13 refers. We are sorry for the delay in responding to
you on this occasion and apologies for any inconvenience caused.

 

We would be grateful if you could please confirm and acknowledge receipt
of this email.

 

We trust this is satisfactory but if you require any further information
or wish to discuss this matter further, please do not hesitate to contact
us.

 

Yours sincerely

 

Gio

 

Giovanni Cerisola

Information Governance Manager

 

Central Manchester University Hospitals NHS Foundation Trust

Room 341, 3^rd Floor, Cobbett House

Manchester Royal Infirmary, Oxford Road

Manchester, M13 9WL

Tel: 0161 701 0375

Email: gio.cerisola[1]@cmft.nhs.uk

 

[2]www.cmft.nhs.uk  Central Manchester University Hospitals NHS Foundation
Trust includes: Manchester Royal Infirmary, Manchester Royal Eye Hospital,
Royal Manchester Children's Hospital, Saint Mary's Hospital, University
Dental Hospital of Manchester, Trafford Hospitals and Community Services.

 

[3]Brand StripeBrand Stripe

 

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We don't know whether the most recent response to this request contains information or not – if you are Neil A. Carter please sign in and let everyone know.