Plans to partially privatise York Hospital A&E slammed

York Central MP Rachael Maskell claimed York Teaching Hospital NHS Foundation Trust was being 'irresponsible' by seeking to outsource some services, including initial assessment and minor injury care, when it should be fully focused on the pandemic and addressing the significant backlog in appointments.

The trust has defended the proposed changes, which it says will help reduce overcrowding at A&E.

She said she was intervening on behalf of constituents and hospital staff over the proposals to outsource work to Vocare, a wholly owned company by profit-making company Totally PLC.

She said previous proposals to embark on this privatisation had been put on hold and the Royal College of Emergency Medicine clearly stated that Emergency Departments should decide who is treated in Emergency Departments, not third party or private organisations.

"While doctors and nurses working in the Emergency Department want to ensure that there are good mechanisms in place for patients requiring less intensive input, due to sustaining a minor injury or illness, they are clear that they must have oversight of the full patient journey for all patients attending the emergency department and determine how and where they are seen," she said.

She said she had written to the Health Secretary, the Trust, Commissioners and Vocare, and had launched a Parliamentary petition so residents could have their say, which can be found at https://www.megaphone.org.uk/petitions/privatisation-of-york-hospital-s-emergency-department.

“It has been a very difficult year for the NHS and its staff who have served our community so well throughout this crisis," she said.

"As the lockdown measures are loosened, the Prime Minister warned that infection and hospitalisation rates will rise, and yet the Trust are distracting from the focus needed to get us all through this pandemic by outsourcing some services, including initial assessment and minor injury care to Vocare. This is irresponsible.

“Staff do not want to see these changes go ahead as it will be detrimental to maintaining staff skills and clinical supervision, as has been seen elsewhere where these measures have been introduced. These measures are so unpopular with staff who benefit from treating a range of clinical presentations transferring skills from treating more significant trauma to less serious injuries and illnesses.

“There is something very special about working for the NHS; we have all sensed that pride this year. I had the privilege of working in the NHS for 20 years, and cherish every moment, so understand why this is so special. NHS staff do not want to work for private companies, and where this has been modelled elsewhere, they leave the service to go back into the NHS elsewhere, leaving recruitment issues.

“This plan is ill-conceived and is in the interests of no-one except the profit-making company which is to gain from this move."

A group of concerned A & E clinicians, nurses and administrative staff in the department, called Keep York Urgent Care Public, said the Executive Team of York Teaching Hospital NHS Foundation Trust had recently agreed, with NHS commissioning colleagues, to potentially allow a portion of the work they currently did in A&E to be carried out by Vocare.

"We wish to inform the public of York about this potential arrangement and indicate our opposition to it," they said.

They said they were concerned that Vocare would seek to reduce costs in areas such as training for staff, the complexity of the cases they were prepared to see and the time allowed for each consultation.

"This will mean that the quality of care provided for patients presenting with urgent care needs and with minor injuries to York Hospital will be diminished," they claimed.

"Staff are also concerned that despite early promises to the contrary, Vocare will eventually take over their contracts of employment and that ultimately, they will no longer work directly for the NHS.

"For many staff, there is significant pride in working for the NHS, particularly in this last year and there is genuine upset about this, as well as concern that working terms and conditions will not be as good as for those staff directly employed by the NHS.

"These plans are being justified because healthcare commissioners want to ensure that York Hospital offers a service which complies with the service specification for an Urgent Treatment Centre (UTC). "These specifications include that the UTC is led by GPs, is open at least 12 hours a day and that appointments are made available via NHS111, GPs and the ambulance service for patients with urgent but not emergency health care needs, including patients with minor illness and minor injury.

"We are not in any way opposed to the principles of Urgent Treatment Centres.

"However, we believe that York A&E already provides excellent NHS care for all its patients including those with minor (and not so minor) injury through our team of highly skilled, experienced and motivated staff. We can see no valid reason why the streaming of patients who attend York A&E and the management of our minor injury service should be outsourced to a private provider.

"We urge the Trust and its commissioners to think again about how it plans to provide a UTC in York and to consider other options including employing its own GPs directly to run and manage the service, alongside its own A&E and minor injury service staff. We are aware that such an approach already works well in other parts of the country."