People can be very quick to run down the National Health Service and I don’t like that – not least because the staff who work for the NHS are fantastic.
But they’re let down by the infrastructure. So much has been crammed on to the Royal Sussex County Hospital site – too much if you ask me.
And so often it’s where people go when they’ve got something wrong with them, even though they might be better off seeing their GP or a pharmacist.
Of course, it’s not always easy to see a GP and part of the reason is that we’re building more and more homes but we have fewer GP surgeries and fewer pharmacies than 10 or 20 years ago.
We’ve got fewer hospitals too. There were nine or more in Brighton and Hove in my lifetime. And at least three of those have been given over to housing.
Work stood still for quite a while at the old maternity hospital, in Buckingham Road, Brighton, although recently it seems to have started again.
Housing also looks likely at the top of Elm Grove, with the loss of the Brighton General as a hospital worthy of the name.
While across town, Hove General Hospital, in Sackville Road, closed almost 30 years ago and was turned into dozens of flats and called Tennyson Court.
When the hospital shut, the people of Hove were promised a replacement. The nearest we got was the polyclinic, on the old Holmes Avenue allotments, with Mill View on the same site.
Now, there’s so much more housing in the pipeline and it’ll put more pressure on our few remaining hospitals – and on their hard-working staff.
But one piece of land, where more than 1,000 homes are planned, holds out the chance to bring things back into balance a bit – Toads Hole Valley.
Plans to put a secondary school there have been dropped and outline permission was granted for even more homes.
It would be better if there’s a rethink before the detailed plans start going in to the council.
How about a small unit there for things like minor injuries to save people going all the way over to the Royal Sussex when they don’t really need to be in A&E?
It could even double up with a doctors’ surgery. Hove Medical Centre has outgrown its current home.
There’s only so much they can shoe-horn on to the jam-packed Royal Sussex site.
And as the last few big parcels of land inside the bypass are built on, this could be the last chance to serve Hove and ease the pressure in Brighton.
Dawn Barnett served as a Conservative member of Brighton and Hove City Council for Hangleton and Knoll from 2004 to 2023.
In my opinion, the real opportunity lies in community-based healthcare – a massively underutilised area.
Pharmacies need a huge overhaul, especially considering we have the proven technology for automated dispensing, which frees up a lot of what can be done within the pharmaceutical paradigm, unchaining Pharmacists and Pharmacy Technicians and creating capacity.
A trip to the Sussex County A and E is likely to leave you traumatized and exhausted even if you were not before. Having worked in 1980s Eastern Europe I never saw anything so horrifyilg as this place even during the weekday let alone on a Friday or Saturday night. The prudent use of polyclinics and centres for minor injuries, alcohol and drug related issues kept the emergency services for just that. Diagnostic units provided swift xrays, scans and more serious investigations. How staff can be expected to function professionally is a mystery yet most do. The appalling state of Royal Sussex A and E has been known for years. I personally experienced it during the 1990s and it is worse now. Yet in the same hospital we have the beautiful new spaces appropriate for a 21 century hospital.
Improvements are promised but not immediately. Why was this essential services not given priority? What is the point of ringing 111 or calling an ambulance only to be taken to this crazy trolley park? Surely it is not beyond our polititions, highly paid NHS executives and builders to work out a better use of the resources we have and stop our newspapers being full of serious reports of inexcusable waiting times that have on occasion led to preventable deaths?
Sadly, Diane, you are right. I was taken there by ambulance last year and held on a trolley in a queue (nearly out the door) for what seemed like ages. Had I not had what was perceived as an urgent emergency in the queue I think I would still be there. Fortunately for the patient and only the patient, the ambulance crew have to stay with you until you are handed over to medical staff, but this is a total waste of their skilled time when they could and should be out there dealing with emergencies. I was taken to RSCH A&E around 20 years ago with a very minor emergency – it was dire then and, as far as I can see, has just got worse.
After that you are shunted into a huge ward-like area on the trolley ,constantly being shunted around to make room for more trolleys/ beds until they decide whether you should be admitted or not (some of the people in this area were not seriously ill and had, perhaps, fallen and cut themselves badly, and were eventually patched up and discharged). Additionally, there were at least two corridors that were officially called ‘wards’, although they were just corridors. When you got out of this area they held you in a cubicle elsewhere until they found you a bed. Many of the staff were brilliant but others weren’t so good.
Dawn is correct. There should and must be other places to deal with basic procedures and minor emergencies.
It defies belief that a mint of money was spent on the Louisa Martindale building (and the infamous helipad) when A&E was all along a total shambles – A&E should have been the priority. I never want to go back in there and hope I won’t, but there isn’t anywhere else, unfortunately.
I was fortunate to get out of the place in just over 2 weeks and would never want to go back, but there is nowhere else. Dawn is right – there should and must be more places to deal with basic stuff and minor emergencies rather than cramming everyone into RSCH A&E. I was taken there around 20 years ago for a minor thing – it was horrid then and hasn’t changed that much – and certainly not for the better.
It seems that all the money has been spent on things like the Louisa Martindale building (which, when I was there, seemed like a tower block of cavernous corridors with nothing much going on) and the infamous helipad, when first and foremost they should have sorted out the A&E fiasco.
Nah, the ambulance crew has a 45-minute policy to handover (Although a year ago it may have been up to 90 minutes, each area is different), then they leave. There are development plans to double A&E last I heard, and you probably saw people waiting for UTC since it’s next door to A&E and deals with the minor procedures and injuries, not to mention there are always a good proportion of people who don’t need to be at the hospital, and some who could have been treated at home, care homes are in particular the worst for the latter.
Fun fact: Resus, the emergency part of A&E, only has four beds in Brighton.
There are other alternatives; they do exist. Hove Polyclinic, the Walk-in Centre at Brighton Station, your regular pharmacy, Health Hub, GP, Treatment at Home Services – although there is definitely scope for expansion on some of these as well.
Patient education is something that needs looking at as well. When you look at things like how many calls to 111/999 are triaged to Cat 4/5, and that sitting at about 70% last data I saw, it suggests there needs to be more done to enable people to self-care as well.
There are also inefficiencies in just the way people are triaged. For example, someone who’s there because they had a choking episode, is going to need to see ENT, but instead of being triaged directly to ENT, you have to be processed by A&E first, wait around for a doctor to become available, who then triages you to ENT.
Whatever the policy might be in theory, the crew were with me for a lot longer than 90 mins, I can assure you. I was there, you weren’t. As I said, I had a perceived emergency whilst in the queue, which might have lengthened the period they were there., but they were there for a very long time. I was suffering from physical issues, not a mental episode, so please keep your theories and remarks to yourself unless you were actually present on that occasion.
In which case, I shall continue.
Control literally harasses you constantly on the radio if you’re overrunning. They will try to bump you ahead of the triage you are deteriorating. One of their most recent changes is that you normally have 15 minutes after handing over and entering PIN to finish off paperwork and clean up for the next job. It now greens you up (makes you available for job allocation) automatically at 14 minutes. Pure KPI spin, of course.
Personal experience aside, we’re in agreement that A&E needs more capacity.
PS: This was all on a Monday lunchtime – not a Friday or Saturday night.
Funnily enough, NHS statistical reports reinforce this: Monday experiences the highest volume of A&E visits, with mid-morning (around 10:00–12:00) being the busiest time slot.
PPS: Apologies for the somewhat incoherent and repetitive post, but I’m having trouble with posting anything at all on this website and text keeps disappearing, only to re-emerge later. after I’ve typed it again. You probably get the gist though, hopefully.
A&E is stretched, but that’s more down to an entire ward there being full of mentally unwell patients waiting for a space at millview. So actually that needs expanding more than anything.
Another commentator made a good point, what we think of A&E actually isn’t really that. There is A&E which is busy but due to be doubled in size, then right next door is for minor injuries, which is very busy but keeps patients that are not critical out of the A&E.
It’s easy to say the new build should have been A&E but what was in there, wasn’t practical. You had cardio patents using a building with no lift … Old Victorian mess of a building completely impractical. The added space being freed up should benefit A&E equally by aiding more free spaces.
My final point however, I cannot understand the utter madness that was the roadean blind veterans building being sold to make flats. The council or the NHS should have purchased this and used it as a short term care home to reduce bed blocking at the hospital. It wouldn’t have cost much as it was already a care home. The sooner the budget for care sector is removed from councils the better. Drop everyone’s council tax right down and put it in income tax. The money can be put into the NHS to make their own care homes that are not private and ripping the country off.
My sentiment is the same with business rates, get rid of it and put it on to VAT, remove the 90K threshold, it would massively help small businesses and stop so much tax dodging.
Really good point about mental health clogging up the system.
For someone having a crisis, there aren’t a lot of options out there, and in the middle of the night, the only realistic place they can be taken is A&E. Police have also pulled away from attending mental health calls, which, honestly, is a good thing as people tend to trigger worse when they see the uniform.
Ambulance crews do a lot to keep people out of the hospital, when appropriate to do so, but it’s limited by what’s available outside of the hospital. When it comes to mental health, there’s not a lot. Also, paramedics have no formal training in mental health. College of Paramedics was playing around with the idea of a Mental Health Specialist role a while back, but then you run into the same problem of capacity again.
Personally, I don’t think mental health falls into the emergency category – it’s typically a long-term condition which isn’t going to be resolved overnight.