"We're doing better than the NHS"

Thursday 03 March 2022

Hospital services in Guernsey are outperforming the UK National Health Service despite falling short of a range of key targets on waiting times.

An annual report on performance in secondary healthcare released yesterday showed that one of the key targets missed was in the emergency department.

89% of people seen in the emergency department were admitted or discharged within a four-hour period last year. This was below the target of 95%.

But the island's Medical Director, Dr Peter Rabey, said the figure achieved was an indicator of success, not failure.

He said the efforts of the emergency department should be praised.

“The department should be incredibly proud of the 89% figure. They work against a lot of disadvantages to achieve this and, unlike the National Health Service, they are not gaming their figures," said Dr Rabey.

Pictured: Hospital waiting times in Guernsey are generally shorter than in the UK.

The National Health Service also has a 95% target for dealing with emergency department patients within four hours, but it met this target in only 74% cases in 2021.

“I have worked in the highest levels of management in NHS hospitals and we used to have beds attached to the emergency department where patients would be put at three hours and 58 minutes just to appear to meet the four-hour target,” said Dr Rabey. 

“We do not have these beds in Guernsey. Our waiting times are a real reflection of the situation and to achieve 89% is fabulous.”

Dr Rabey said that the National Health Service has not met its 95% target “since around 2007”.

Pictured: Day case unit to inpatient conversion rate targets were met in 2021. 

Medical Specialist Group Chairman Dr Gary Yarwood said that Guernsey’s key performance indicators in secondary healthcare are set using NHS targets as a benchmark.

“We use the NHS as a benchmark and we have outperformed their result despite a very different set up and more challenges,” said Dr Yarwood.

“A lot of emergency departments in the UK will have admissions units next to them to move patients across quickly. They also often have CT scanners in the department so that patients can be given scans quicker. We do not have these options in Guernsey.”

Dr Yarwood said that having fewer staff was also a challenge for the emergency department locally. 

“We have a consultant-only model in Guernsey, so if you attend the emergency department with a broken hip, for example, and the orthopaedic surgeon happens to be in theatre attending to a broken ankle, then you can’t be seen," he said.

“In the UK, there would be a whole team of people available, so someone else would be able you see you.

“Although the 89% result does not quite meet the target, it is a very laudable performance”.

Pictured: Targets for unplanned returns to theatre within 30 days were met in 2021.

Dr Yarwood said that “patient-centred” targets were met in 2021.

“The key performance indicators for readmission rates, hospital infection rates and return to theatre rates were all very low and on target,” he said.

“We also had a very low unplanned admission rate to the day patient unit, despite extending the opening hours. This proves that we did not extend the hours inappropriately.

“These results can be credited to a lot of factors, including good clinicians, good nurses and a very clean hospital."

Pictured: Targets for emergency readmission rates within 28 days of discharge were met in 2021.