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| NHS guidelines for 'major incidents' spark political row | NHS guidelines for 'major incidents' spark political row |
| (35 minutes later) | |
| Guidance issued to NHS hospitals in the West Midlands over when they can call "major incidents" has sparked a row between the Conservatives and Labour. | Guidance issued to NHS hospitals in the West Midlands over when they can call "major incidents" has sparked a row between the Conservatives and Labour. |
| Hospitals have been told to consider 17 criteria, including the availability of extra beds, the status of ambulances and community capacity, before acting. | Hospitals have been told to consider 17 criteria, including the availability of extra beds, the status of ambulances and community capacity, before acting. |
| Labour said the move was "more about news management than patient safety". | Labour said the move was "more about news management than patient safety". |
| Health Secretary Jeremy Hunt said it was a "local decision" and accused Labour of "cynical exploitation". | Health Secretary Jeremy Hunt said it was a "local decision" and accused Labour of "cynical exploitation". |
| The row comes as the Conservatives and Labour argue over the relative performance of the NHS in England and Wales in the run-up to May's election. | The row comes as the Conservatives and Labour argue over the relative performance of the NHS in England and Wales in the run-up to May's election. |
| Figures published on Wednesday show the proportion of ambulances in Wales, where the health service is run by Labour, meeting the target response time for the most urgent calls are the worst on record. | Figures published on Wednesday show the proportion of ambulances in Wales, where the health service is run by Labour, meeting the target response time for the most urgent calls are the worst on record. |
| It also comes amid a dispute within Labour ranks over its health policy, with former health secretary Alan Milburn warning it risks retreating into a "comfort zone" where it is focused on resources rather than reform. | It also comes amid a dispute within Labour ranks over its health policy, with former health secretary Alan Milburn warning it risks retreating into a "comfort zone" where it is focused on resources rather than reform. |
| The new guidelines for major incidents have been issued by the West Midlands NHS region to hospitals, GPs and Ambulance Trusts in their area - which includes Birmingham, Coventry and Wolverhampton. | The new guidelines for major incidents have been issued by the West Midlands NHS region to hospitals, GPs and Ambulance Trusts in their area - which includes Birmingham, Coventry and Wolverhampton. |
| It is understood they were drawn up after a spate of major incidents this month due to pressure on bed spaces. | It is understood they were drawn up after a spate of major incidents this month due to pressure on bed spaces. |
| Hospitals in Staffordshire, Gloucestershire, Cambridgeshire, London and Surrey were among those to declare a major incident, which triggers extra measures, such as calling in off-rota staff and cancelling non-emergency care like routine operations. | Hospitals in Staffordshire, Gloucestershire, Cambridgeshire, London and Surrey were among those to declare a major incident, which triggers extra measures, such as calling in off-rota staff and cancelling non-emergency care like routine operations. |
| 'New hurdles' | 'New hurdles' |
| Among the "checklist" of issues that hospitals in the West Midlands are now being asked to consider is whether elective operations have been cancelled so staff can be redeployed for emergency care, how many ambulances are waiting to deliver patients and the position elsewhere in the surrounding area and whether all alternative bed spaces have been utilised and are staffed. | Among the "checklist" of issues that hospitals in the West Midlands are now being asked to consider is whether elective operations have been cancelled so staff can be redeployed for emergency care, how many ambulances are waiting to deliver patients and the position elsewhere in the surrounding area and whether all alternative bed spaces have been utilised and are staffed. |
| These factors, it says, "should be used as a guide to the level of information that a trust should have in place before raising any further steps required". | These factors, it says, "should be used as a guide to the level of information that a trust should have in place before raising any further steps required". |
| A spokesman for NHS England denied the guidelines were designed to deter hospitals from declaring a major incident. | A spokesman for NHS England denied the guidelines were designed to deter hospitals from declaring a major incident. |
| He said: "This is not a note saying don't call a 'major incident'. It is advice to them saying if they are going to declare a major incident here are some things that might help." | He said: "This is not a note saying don't call a 'major incident'. It is advice to them saying if they are going to declare a major incident here are some things that might help." |
| Mr Burnham told the BBC that clarity was needed on the circumstances around a major incident but it appeared that "new hurdles are being created" which would make it "impossible" for some hospitals to enter such a mode. | Mr Burnham told the BBC that clarity was needed on the circumstances around a major incident but it appeared that "new hurdles are being created" which would make it "impossible" for some hospitals to enter such a mode. |
| Mr Burnham, who has been granted an urgent question on Parliament on the issue later, asked Mr Hunt to clarify whether he was aware of the new guidelines, whether he approved them and why they had been introduced "so abruptly". | Mr Burnham, who has been granted an urgent question on Parliament on the issue later, asked Mr Hunt to clarify whether he was aware of the new guidelines, whether he approved them and why they had been introduced "so abruptly". |
| What is a major incident? | |
| An internal major incident is activated when a Trust is under significant pressure that is internal to the organisation - and is not the result of an external event. | |
| It is a business continuity arrangement, where a decision is taken to reduce some services to support higher priority ones. | |
| A major incident is a significant incident or emergency that cannot be managed within routine service arrangements. | |
| It requires the implementation of special procedures and involves one or more of the emergency services, the NHS or a local authority. | |
| Source: NHS England - London region | |
| "Procedures for declaring major incidents are long-established in the NHS and it is a highly unusual move for new guidance to be issued in the middle of a difficult winter," Mr Burnham said. | "Procedures for declaring major incidents are long-established in the NHS and it is a highly unusual move for new guidance to be issued in the middle of a difficult winter," Mr Burnham said. |
| "On the front line, people perceive this as being more about news management than patient safety." | "On the front line, people perceive this as being more about news management than patient safety." |
| In an email exchange seen by the BBC, a head of operations at one NHS Trust in the West Midlands region says he believes the guidelines have been introduced "to effectively stop trusts from calling a major incident". | In an email exchange seen by the BBC, a head of operations at one NHS Trust in the West Midlands region says he believes the guidelines have been introduced "to effectively stop trusts from calling a major incident". |
| He writes: "This is the enhanced criteria that have been introduced by NHS England to effectively stop trusts from calling a major incident. Worth sharing with emergency department consultants as our hands will be tied in most cases if they wish to call a major incident for capacity reasons." | He writes: "This is the enhanced criteria that have been introduced by NHS England to effectively stop trusts from calling a major incident. Worth sharing with emergency department consultants as our hands will be tied in most cases if they wish to call a major incident for capacity reasons." |
| In the same email exchange, an A&E consultant says: "It strikes me as an attempt to dampen down the heat and media attention on the emergency departments and their major incidents." | In the same email exchange, an A&E consultant says: "It strikes me as an attempt to dampen down the heat and media attention on the emergency departments and their major incidents." |
| 'Political pointscoring' | |
| Mr Burnham said such concerns were a "very serious matter" and clinicians seemed to have "interpreted this guidance as a move to keep A&E pressures out of the news". | Mr Burnham said such concerns were a "very serious matter" and clinicians seemed to have "interpreted this guidance as a move to keep A&E pressures out of the news". |
| But Mr Hunt hit back, insisting that he had nothing to do with the move. | But Mr Hunt hit back, insisting that he had nothing to do with the move. |
| He tweeted that it was a "local operational decision in West Midlands which had nothing to do with ministers being cynically exploited by Mr Burnham for politics". | He tweeted that it was a "local operational decision in West Midlands which had nothing to do with ministers being cynically exploited by Mr Burnham for politics". |
| He added: "Labour should focus on improving care for patients in Wales instead of trying to score political points in England." | He added: "Labour should focus on improving care for patients in Wales instead of trying to score political points in England." |
| A senior NHS executive said decisions on major incidents were not taken by ministers but by management locally. | |
| "Before doing so best practice dictates that they take account of the wider impacts on other parts of the NHS so that patient safety in the round is protected," said Dr Barbara Hakin, National Director of Commissioning Operations for NHS England. | |
| The government has acknowledged the NHS is facing acute pressures this winter but has defended its performance and said additional funding is being made available. | |
| The NHS in England missed its four-hour A&E waiting time target between October and December, with performance dropping to its lowest level for a decade. | The NHS in England missed its four-hour A&E waiting time target between October and December, with performance dropping to its lowest level for a decade. |
| Figures published earlier this month showed that 92.6% of patients were seen in four hours - below the 95% target. | Figures published earlier this month showed that 92.6% of patients were seen in four hours - below the 95% target. |