Doctors’ strike leads to 6,500 cancelled appointments across local NHS trust

NHS trust which manages Chase Farm Hospital is struggling with a backlog for cancer treatment, reports Simon Allin, Local Democracy Reporter

Royal Free London NHS Foundation Trust runs Chase Farm Hospital in Enfield
Royal Free London NHS Foundation Trust runs Chase Farm Hospital in Enfield

Recent strike action led a hospital trust to cancel more than 6,500 appointments – and delays to cancer treatment are now a significant concern.

The Royal Free London NHS Foundation Trust reported that its performance on cancer treatment “continues to be significantly affected by industrial action” as clinicians were diverted to urgent and emergency care during strikes.

The strikes are also having an impact on the trust’s finances, which are £26.1million in the red – £9.5m more than expected.

As well Royal Free Hospital in Camden, the NHS trust manages Barnet Hospital, Edgware Community Hospital and Chase Farm Hospital in Enfield.

NHS staff have staged a series of walkouts this year over pay and working conditions. The latest strike by junior doctors took place from 13th-18th July, followed by a 48-hour strike by consultants from 20th-22nd July. The British Medical Association says junior doctors’ pay has fallen 26% in real terms since 2008 and warns many are planning to leave the NHS.

A further junior doctors strike is due to take place from 11th-15th August.

Details of the impact of strikes to date were presented to a meeting of the trust’s board on Wednesday (26th). Chief executive Peter Landstrom told the meeting that the strike action was “having its toll”. He added: “Over the last period of industrial action, we as a trust had to cancel over 6,500 patient appointments.

“We worked incredibly hard to rebook them all, but obviously that is a vast number, and we are starting to see this come through now in terms of some of the pressures on our overall numbers of patients waiting for elective care, including some cancer patients as well. We are obviously really concerned about that and responding to it.”

A report presented to the board meeting revealed that in May, before the latest round of industrial action, 42.9% of the trust’s patients were treated within 62 days of an urgent GP referral for cancer – well below the 85% NHS standard. It means Royal Free London ranked 112th out of 120 trusts for its performance in this area.

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The number of patients waiting longer than 62 days for cancer treatment increased from 386 in April to 418 in May, the figures show.

Performance against the faster diagnosis standard also declined in May, with 66.7% of patients diagnosed or having cancer ruled out within 28 days of being referred for suspected cancer, compared to 69.5% the previous month.

Peter said the trust was supporting staff who chose to take industrial action “but obviously focus[ing] on our primary aim, which is to keep our services safe”.

He told the meeting that the loss of capacity caused by the strikes was “really starting to impact”, with “a growing number of patients that will need treatment”, adding that the trust will need to “reprioritise our theatre capacity and our resources to support some of that surgery”.

Peter noted that there had been improvements in some areas – particularly in urgent and emergency care, where all of the departments performed “above their recovery trajectories”.

Barnet Hospital has moved from one of the lowest-performing emergency units in London to above average, he explained.

During a separate update, the trust’s chief finance officer, Vicky Clarke, said £1.4m of its deficit was caused by a breakdown in its power plant, meaning it had to buy energy on the open market.

She added that strike-related costs totalled £2.4m – partly caused by paying “additional premiums to provide safe cover during that time” – although this would change as the government had already agreed funding to cover some industrial action.

Sickness rates had also increased as staff worked longer hours to cover strikes, she added.

A further strain on finances is being caused by capacity issues preventing private treatment from returning to pre-pandemic levels. Vicky said it would be a “challenge” to identify further savings but insisted that “they do exist”, and the trust was working on efficiencies in several areas.

She pointed out that if strike days were excluded, the trust’s elective recovery plan – designed to tackle backlogs in patient care caused by the Covid-19 pandemic – was ahead of schedule.

Group chair Mark Lam noted that the trust would work on “transforming our care and not cost-cutting” to improve performance.

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