As A&Es continue to struggle under government targets and budget cuts, STEVE CANAVAN begins a series of features by speaking to the man tasked with keeping Blackpool Victoria Hospital’s own department ticking along.
If you are the glass half-empty type, you might say Simon Tucker has a thankless task.
He is the man in charge of the busiest and most stressful department at Blackpool’s Victoria Hospital - Accident and Emergency.
The busiest part of any hospital, it is also the target of most complaints - chiefly the length of time it takes to see a doctor.
You know the stories, someone turns up with a sprained ankle or a bad cut and has to wait hours in the waiting room.
The Vic is better than most in this respect. Generally speaking, it hits the government target that stipulates 95 per cent of patients must be seen within four hours. In recent times it has been rated the best hospital in Lancashire on this score.
Of course there are challenges, and you might say I’m a glutton for punishment
It goes without saying that this pleases Tucker, but he makes no apologies for some patients having to wait.
“Basically the way I look at it is that the A&E department is the first leg of a relay race. We get the baton - the patient - and we want to pass it on as quickly as possible,” he says.
“Now I understand it’s frustrating for people who think they are waiting too long to be seen, but they’ve got to realise it is always because there is another patient with a greater need.
“A lot of patients come to us with minor injuries. They are important but the bottom line is that the patient who has the cardiac arrest and can’t breathe is the priority. Delays in treating them can be life or death.
“But we can’t come out and tell people waiting that every member of our team is tied up desperately trying to save, say, a baby’s life because of patient confidentiality.
“So all I would say is that if you are waiting, don’t think it’s because we are sitting around not doing anything, it is just that the department is very busy.”
The pressure on A&E departments in every hospital throughout the country is great.
But in Blackpool, a town top of just about every ‘bad’ list from alcoholism to mental health, and teenage pregnancies to heart disease, it is immense.
It seems to me, therefore, that if you are in the medical profession and want an easy life, surely you’d be mad to want to work in Blackpool. Why not go somewhere nice and cushy?
Tucker, a 38-year-old, who looks remarkably young given the intensity and high-stress nature of his job, looks at me like I’ve lost the plot.
“I’ll tell you why,” he says. “Because I think it’s much better being in a place where you can make a difference than being somewhere that just ignores and doesn’t want to strive for excellence.”
Tucker knows Blackpool well. After moving to England from his native Northern Ireland, he started his medical career at the Vic as a junior doctor. So he is very aware of the town’s problems.
And the satisfaction for him derives from knowing that if he creates a better hospital and health service, it will help improve an entire area. That, he argues, is what make the Fylde coast such a rewarding place to work.
“Of course there are challenges, and you might say I’m a glutton for punishment,” he says. “But here there is a real opportunity to improve our service and achieve what we want to achieve - which is to help the whole of Blackpool.”
One of the big problems Tucker faces as he strives for these improvements is getting staff in.
Working in A&E is unique and exciting for any medic. They are on the frontline, the first to deal with everything from a football injury to victims of serious car crashes.
But it’s hard work, the hours can be long and unsociable, and the stress of it isn’t for everyone.
There were three consultants running A&E when Tucker arrived at Blackpool five years ago. Now there are seven which, says Tucker, “is why I think things have vastly improved in the last few years”.
But there is funding - and this is surprising given the horror stories of financial cuts to the NHS - for 10 consultants, it’s just that the Vic is struggling to find the staff to fill the roles.
“It’s our location that is the problem,” explains Tucker, in between breaking off to answer the pager he always carries, which seems to beep every other minute to alert him to some issue somewhere within the department.
“When senior doctors hit the stage where they are looking to become consultants, they are often married with kids and settled in a location - and moving to the end of the M55 is not an attractive option.
“That is one of the unique aspects about Blackpool as a hospital and one of our biggest challenges.”
One thing that Tucker prides himself on - and believes is vital - is listening to criticism and, instead of being in denial about problems, trying to do something about them.
As an example he cites the storm which erupted at the start of 2013 when it emerged that the Vic was one of five hospitals to be investigated by the NHS Commissioning Board following two years of worryingly high death rates aftertreatment.
“It was a fine example where people didn’t get dismissive or make excuses. We said ‘hang on a second, there is a problem here’ and we did something about it,” he says.
The hospital introduced a new working practice called Clinical Pathways.
A year later it recorded its lowest mortality rates since 2011.
“And that’s why I like working here because that’s the kind of can-do attitude we have in Blackpool. We pick ourselves up and get on with it,” adds Tucker.
In the last five years, the A&E department has been redesigned and refurbished and Tucker says he is “very proud” of the service being offered to the people of Blackpool.
“It’s tough here because it is a unique area,” adds Tucker.
“There is deprivation, there are alcohol-related and drug-related problems, issues with teenage pregnancy - and on top of that we’ve got an ageing population.
“All these are things that increase the risks to people when they become unwell. But that is just the nature of Blackpool and it’s what we have to deal with.
“You are not going to please everyone all of the time, that is impossible, but we have worked really hard, and continue to work really hard, to improve our A&E department and to give the people of Blackpool a hospital to be proud of.”
Tucker pauses, thinks a moment, then adds: “As the staff who work here, we are all very aware of the reputation of our department.
“When things go right, we take the pat on the back.
“When things could have been done differently, or better, we are quick to identify how and develop things to make sure it doesn’t happen again.
“We’ve made huge strides in recent times and I think we offer the people of Blackpool a very good service ... in fact I am really proud of it.”
With that, he is off. To treat a patient, to go to a meeting, to fix a budget, to deal with a complaint, or to complete one of the many other tasks his job entails.
Hospitals and A&E departments don’t always get good press and, it must be noted, don’t always deliver a first-class service.
But you get the feeling that with someone like Simon Tucker in charge, and with the enthusiasm and commitment he brings, Blackpool’s Victoria Hospital is in safer hands than most.
TOMORROW: How GPs are trying to ease the burden