THE COUNTRY’S NHS services have seldom been under more pressure.

As senior doctors nationally warned that the pressures facing the NHS were becoming “intolerable and unsustainable”, the News & Star has investigated whether Freedom of Information laws can throw light on the state of Cumbria's health services.

The professionals managing these vital services – including in Cumbria - are routinely asked to explain the challenges they face.

Stress levels, the crisis in A&E departments, and delayed hospital discharges... all these issues challenge Cumbria's NHS. 

The News & Star has reviewed how locals used their right to know about services provided by North Cumbria Integrated Care NHS Foundation Trust.

The organisation, which employes more than 4,000 people, runs The Cumberland Infirmary in Carlisle and West Cumberland Hospital in Whitehaven as well as a wide range of community-based health services.

The organisation’s “disclosure log” lists  dozens of questions that officials have been asked about under Freedom of Information laws - and they provide a fascinating insight into Cumbria’s NHS services.

This article presents just some of those insights. The questions include ones about the following issues:

A&E and child mental health. Among the most worrying statistics were those relating to children who arrived at - or were taken to - A&E in Carlisle and Whitehaven because they needed emergency help for a mental health issue.

The figures suggest an underlying issue that must be blighting the lives of scores of children in north Cumbria. In 2019, 383 children needed A&E help for mental health problems. The following year, the figure was 336 but during 2021, the figure had surged to 424.

Equally concerning are figures for the longest waiting times spent at A&E which children among this group experienced. In the year to March of last year, the longest a child had to wait in A&E was just over 22 hours. The next longest waits were 13 hours and 12 and a half hours.

During the first three months of last year, the figure stood at 137. The worst month for children seeking A&E help for their mental health was May, 2021, when 67 youngsters arrived at the departments in Whitehaven and Carlisle.

Delayed hospital discharges. This issue has been said to be central to the ability of hospitals to move patients from hospitals on to wards. One FOI question asked the Trust how many patients were staying in hospital despite being fit for discharge.

The answer, relating to the years 2020, 2021, and April to May of last year, reveal a steady rise in so-called “bed blockers,” - patients who were medically fit for discharge but who could not leave hospital for reasons which were not disclosed. Over those years, the figure for the Trust rose each year, from 57, to 94, and last year to 129. The Trust confirmed that between April and May last year, 40 of those patients were in hospital for more than 21 days.

The FOI answer also revealed the longest spell for each fit-for-discharge patient in each year. In the 2021 financial year, one fit-for-discharge patient was in hospital for 86 days while the following year, the longest medically unnecessary stay was 214 days. In the first two months of the most recent financial year, one patient had chalked up 113 days beyond the fit-for-discharge date.

Emergency treatment for injuries inflicted by dogs. The question asked about how many people went to the Trust’s A&E Departments after being injured by a dog. 

In 2018, 218 people sought A&E help at both hospitals for injuries inflicted by dogs. In 2019, the figure was 428, while the following year it fell to 362. By 2021, there was yet another reduction, with 357 seeking emergency treatment for injuries caused by dogs.

Staff sickness rates. The questioner asked the Trust to provide a breakdown for how many work days were lost over the last two years because of staff absence through sickness. The total number of sick days taken by staff working for the Trust was 225,317.

The answer also breaks down the various reasons for those sick days – and by far the most common reason for sickness absence was “stress, anxiety, depression or some psychiatric illness. Of the total sick days were taken, 68,384 days were taken for this reason.

The second most common reasons were “infectious diseases” (32,091 days), and “musculoskeletal problems” (21,729 days). Just over 9,000 sick days were down to colds, coughs and flu), “pregnancy related disorders” were behind 5,856 sick days.

Hospital Departments with a notably high number of sick days included a stroke ward (3,390 sick days taken), and Radiology, where just over 4,000 sick days were logged; as well as A&E at The Cumberland Infirmary where 3,428 sick days were taken and the hospital’s General Theatres Department where 4,805 sick days were recorded, while the same department in Whitehaven recorded 4,270 days lost through illness.

At the ICU ward of West Cumberland Hospital, 2,692 sick days were logged. Among the very low sickness rates were those recorded by the Keswick Radiography team (2.6 days), and the Trust’s Tier 3 Weight Management team (1.16 days), and the Trust’s “Performance and Information Team,” who logged just one day due to sickness.

Physiotherapy waiting times. Over the three years 2019, 2020 and 2021, figures revealed a steady increase in waiting times for physiotherapy at the trust. During those years, average waits for those referred for physiotherapy rose – from 10 weeks, to 18 weeks, and then, for 2021, to 30 weeks, according to a Freedom of Information Request response.