On the eve of the funding debate for Jersey’s Future Hospital, three senior clinical representatives have written an Open Letter to States Members, urging them to support the proposition.
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Open Letter to All States Members
Sunday 10 December, 2017
Dear States Member,
You are due to vote on the funding proposition for our Future Hospital this week.
As the senior clinical representatives within HSSD, we are asking you to vote in favour of the proposition, because any further delay could have serious consequences for the people of Jersey – our patients.
We are fortunate in Jersey to have excellent, experienced and committed staff working in our hospital – people who give of their very best every day to provide quality care to Islanders. However, they are increasingly hampered by the current physical environment.
We know that you understand the need for a new hospital and we understand that you have debated the site and approved a new build on the existing site. Despite this being more complex from an operational point of view, it is manageable. We are desperately keen to make this work and to get started, because completing our new hospital is becoming time critical.
From a clinical perspective, we need to reiterate why time is of the essence and why any delay in taking this decision creates clinical safety concerns.
Firstly, we have to manage acutely unwell patients in facilities that do not match their needs. In the recent outbreak of diarrhoea and vomiting, we were unable to isolate patients with symptoms due to the lack of single rooms.
This meant that we had to isolate whole bays of beds, taking many beds out of action and exposing more patients and staff to the infection. We also had to cancel elective surgical patients, as we could not use our beds effectively. This is bound to happen more frequently as the years go by.
We do not want a hospital that hits the headlines for all the wrong reasons, as others have done, especially as we know that two key factors in poorly functioning hospitals are multi-bedded bays and poor estate.
Secondly, we are unable effectively to change models of care to reflect best practice due to poor clinical adjacencies and current building configuration.
We are having to care for patients in facilities that do not offer the most basic privacy and dignity. Telling a patient a devastating prognosis with just a thin curtain between them and the patient in the bed next door affords no dignity or confidentiality.
Sadly, we frequently are unable to provide a single room for patients receiving end of life care. We do not think that you would want this for your family, and as professionals we do not want it for our patients. We live with the reality of this every day and we know it is not the best way to care for our patients.
Thirdly, as we approach winter we are already seeing an increase in admissions of patients with acute illness. This is normal for the time of year and normal within an older age group of patients. However, as our population ages we are not able to expand our bed base, so we will find it very challenging to manage this over the next six years, assuming a new hospital will open in 2024.
We will inevitably start to see stresses in the system, with patients having to wait in the Emergency Department for a bed, planned operations regularly being cancelled, more patients having to travel off-Island for care that could and should be delivered here, and increasing waiting lists. All of these stresses can have a clinical safety consequence for our patients and cost implications for the Island.
Fourthly, we frequently have unexpected failures in the infrastructure of the hospital that disrupt our ability to provide optimal care, such as blocked and leaking drains in clinical areas, patient lift failures, electricity failures, and air circulation duct failures. Again, all of these failures have the ability to affect the provision of safe care.
We carry a significant risk in relation to our most critical services as they are located in the 1960s building, which is in the worst condition. The services at risk include the Emergency Department, Intensive Care Unit, Theatres, Chemotherapy Suite and the Children’s Ward. This will remain the case until they are moved to our new hospital.
Lastly, attracting staff to work here is critical to our ability to provide a robust, safe and sustainable service. We are in an increasingly difficult labour market, fishing in the same pond as hundreds of organisations. Showing potential staff around this ageing estate does nothing to promote working here, but at least we can say that there will be an up-to-date, fully-specified, new hospital by 2024. If there is any further delay to this timeline we run the very real risk of not attracting the high-calibre staff we need to bring to Jersey, which in turn can lead to a rapid decline in our health service.
We have heard that if the Proposition is delayed or rejected in December, then due to the 2018 election cycle, this will add at least another year to our timetable and if the site debate is re-opened, then this could be another four or five years’ delay to a hospital that we ought to be opening by then.
For the sake of our patients, your constituents and all of our families, we – as dedicated, professional clinicians – strongly urge you to vote for the proposition.
Medical Director and ENT Consultant
Dr Sarah Whiteman
Medical Director for Primary Care