Urgent care crisis: Woman feared losing leg as 100 people complain about delays

A woman whose leg was saved from amputation by community nurses has raised concerns after experiencing delays and missed appointments in the care she relies on.

Deborah Williams, 73, from Swindon, said early detection previously prevented her leg ulcers from deteriorating but appointments had become harder to obtain recently.

Her experience is among more than 100 complaints from patients and staff to Wiltshire MP Brian Mathew, reporting delays to urgent nursing care and growing referral backlogs.

HCRG Care Group acknowledged problems when its Single Point of Access (SPA) system was introduced in April and apologised to patients. However, it said performance had improved and care remained safe.

Williams said staff who were familiar with her condition and allergies had left and described increasing difficulties obtaining appointments and treatment.

"Lucky if you get the two, you might get one [visit] a week," she said.

She said she had recently raised concerns about signs of a possible infection but felt her concerns had not been acted on quickly enough.

"I could have had an infection and been up the hospital or been on the drip again, or had sepsis, which I've had once before," she said.

She has now written to the Health Secretary about the issue.

Mathew, Liberal Democrat MP for Melksham and Devizes, said the complaints varied from delayed treatments, cancelled appointments to growing pressure on community services.

He said changes introduced through the SPA system were creating frustration for patient and healthcare workers.

"That's resulting in delays in care, increasing administrative burdens and reducing clinical capacity," he said.

Asked whether patients and staff were suffering as a result, he replied: "Yes, I think they are. And I think the staff are suffering.

"It seems like what they're trying to do is cut their costs, but in doing so they're cutting the service."

One woman, who asked not to be named, said her husband, who has a spinal cord injury, relies on urgent catheter care and has experienced delays since the changes were introduced.

She said delays in obtaining help could have serious consequences.

"The catheter needs to be changed...now, because he's at risk of autonomic dysreflexia, which is a serious problem and can kill you," she said.

Because of the spinal cord damage, his brain cannot process pain signals or properly control blood pressure.

The woman said calls to the service could involve lengthy waits and that patients were often told someone would call them back later.

Describing one occasion when she sought help over concerns about a possible infection, she added: "They told me to ring 111 and so I did at about seven o'clock at night and they eventually rang me back at two in the morning and said they were sorry they couldn't ring me back because they were too busy."

The concerns come after the BBC reported the case of Tisbury woman Shelley Crouch, who said she was left caring for her dying mother overnight without support and waited 18 hours for a call back from community nursing services.

A senior manager in the hospice sector in Wiltshire told the BBC there were currently "significant gaps" in the domestic service for dying patients and a lack of clarity about how those issues were being addressed.

HCRG Care Group's regional director Val Scrase said she would not comment on individual cases, but added patients receiving end-of-life care would normally receive support from a wider team including community services, GPs and other care providers.

A district nurse, who asked not to be identified, said staffing shortages and the SPA system were increasing pressure on both staff and patients.

"We have got to the point where in an eight-hour shift you would see eight [patients], we are seeing 12 to 14. It's really bad," she said.

She claimed urgent referrals were sometimes delayed after becoming stuck in the new system.

"We are getting referrals for urgent things three or four days later because they were lost, some are dying patients," she said.

The nurse said staff were often unable to spend enough time with vulnerable patients.

"Patients are definitely suffering," she said. "We see a lot of vulnerable elderly people who cannot go out of the house.

"We might be the only person they see all week and we have to rush."

Another senior clinician, who also asked not to be identified, said some patients were bypassing the telephone system and turning up at clinic unannounced.

"Because of the single access telephone they will simply turn up at the clinic," they said.

"We have fully booked clinics and don't have capacity to see them all the time."

HCRG Care Group, formerly Virgin Care, provides community health and social care services across Bath and North East Somerset (BANES), Swindon and Wiltshire.

It is commissioned by the NHS and local authorities to run services like GP practices, urgent care centres and district nurses in a contract worth more than £1 billion over 7 years.

HCRG Care Services Ltd reported a post-tax profit of £10.6m in its most recent accounts.

All revenue came from contracts with the NHS and local authorities.

Mathew said he had met Scrase: "We've asked them to acknowledge the seriousness of the concerns raised by frontline staff and increase direct engagement between senior management and clinical teams," he said.

Scrase acknowledged there were problems when the SPA system launched in April and apologised to patients affected by delays.

She said the previous system involved more than 200 access points and that commissioners and service users had wanted a single route into community health services.

While the new system initially struggled with demand, she said performance had improved significantly.

"Our response time now, if you ring our point of access, is three minutes to access our adult services and two minutes to access our children's services," she said.

She rejected suggestions HCRG was failing to deliver care.

"Patient safety and quality of care remains our absolute priority," she said.

She said decisions about treatment and visit schedules were made by healthcare professionals based on individual care plans and clinical need.

Asked about claims the company was prioritising profits over care, Scrase said HCRG's performance was monitored by the NHS through quality, safety and financial measures.

"I can absolutely reiterate that my decisions are made on patient safety and quality. I have never had to make a decision based on profit," she said.

She added HCRG was regulated by the Care Quality Commission and had received "good" or "outstanding" ratings in inspections since the contract began.

Responding to concerns about staff leaving, Scrase said workforce data did not support that view.

"We are very proud of the staff that we've got and the care that they deliver, and that is not evidenced that we are losing our staff," she said.

Mathew said he would continue to scrutinise performance closely.

"If we haven't seen improvements, then we're going to have to raise it up a level because we're talking about the healthcare of the people of the area and it's just not acceptable as it is."

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