Cornwall's ambulance queues are nothing we're proud of says NHS boss

The ICS will replace Kernow CCG from July 1 to provide a single NHS voice in Cornwall

Queues of ambulances waiting for hours outside Cornwall’s main hospital are a stain on the NHS that no one is proud of, the boss of the new organisation set up to sort it all out said. Speaking days ahead of the official launch of the new Integrated Care System, its new boss, Kate Shields, said bringing together organisations involved in health and social care across the area, from hospitals, councils and other social care providers, will help reduce the number of bed-blockers in hospital and ensure that people do not end up queuing outside emergency departments when they shouldn’t be there in the first place.

“We know we have ambulances waiting outside hospitals,” Mrs Shields, the chief executive of the new ICS, said. “No one here is proud of that. The aim of the ICS is for health and care organisations and local authorities to work together and speak with one voice in Cornwall for the benefit of patients.” Mrs Shields said she moved from her role as the CEO of the Royal Cornwall Hospitals NHS Trust to her new post, to enact change and ensure such change happens.

“The proof will be in the pudding,” she said. “We have to make sure we have a team in place that looks at the issues across Cornwall. It is about ensuring people are looked after in their own home where they are happy rather than in hospital. When I am old, I know where I’d rather be looked after, and it’s at home with care coming to me rather than in hospital.”

She said that the new organisation’s main role will be to make sure patients have the right care in the right place and don’t all end up bed-blocking at Treliske for days on end. That could mean bringing social care providers on special NHS contracts if necessary. Cornwall’s new Integrated Care System is a new partnership between Cornwall’s hospitals, Cornwall Council and other social care providers and will officially replace Kernow Clinical Commissioning Groups (in operation since 2013) on July 1 when the CCG will not longer exist. It is part of an England-wide restructure of the NHS.

However, last month, Cornwall’s ICS, with a budget of £1.2bn budget, was barely operational and running in parallel with the CCG. The ICS was criticised for not doing the job it is supposed to do. Care Quality Commission (CQC) inspectors found that while individual health and mental health organisations in Cornwall are doing a good job, no one knows what the others are doing. The lack of a coordinated approach is putting lives at risk. Its report found that the “lack of joined up communication across the system” is the reason why people are facing lengthy delays as they wait for assessment and treatment.

In its report on Cornwall’s new ICS, the CQC found that “significant work” is needed to alleviate extreme pressure on urgent and emergency care services across Cornwall and the Isles of Scilly. The CQC found that although many of the services inspected are individually well-run and provide safe care and effective service to people, because they don’t have a clue what the service down the corridor or across the county is doing there is more bed-blocking with people waiting longer to be discharged from hospital, people waiting longer for the right treatment and increasingly exhausted staff as a result of unnecessary pressures.

As a result, ambulances have also been forced to wait outside Royal Cornwall Hospital longer than they should. Kate Shields said ambulance delays have an impact the health and social care system and admitted it is partly due to people within the NHS not talking to each other, something she insisted her new organisation will have to ensure happens. She added that as there is only one organisation now in place it will make it easier to see if it is achieving its objectives.

She said the new ICS was not just about moving managers around and giving them new fancy titles. “It’s a massive opportunity for us to bring together RCHT, Cornwall Partnership Foundation Trust, the voluntary sector, GPs, and Cornwall Council to pull together to make care better for all in Cornwall. We also want to do more work with our communities so communities look after themselves better too.

“I remain hopeful that we will develop the right care for people in Cornwall. We want care to fit around people’s needs rather than be about what service is available.”