THE Royal Derby Hospital has been fined nearly a quarter of a million pounds after missing its accident and emergency targets for the second time in two years.
The hospital is supposed to see 95% of its A&E patients within four hours. In the year to April, it achieved a figure of 93.92.
As a result, it has been fined £248,000 by the NHS Southern Derbyshire Clinical Commissioning Group, the GP-led group which took over local health care services in April.
The hospital, which employs about 7,000, has said it will make changes in a bid to improve its performance, which comes against a backdrop of hospitals across the country struggling to keep down A&E waiting times.
It is the second year running the hospital has missed its target. Dianne Prescott, trust director of strategy and partnership, said hitting the target was a "challenge" it was "working extremely hard to achieve".
Two measures the hospital is planning are spending an extra £500,000 employing more A&E consultants and, in the short-term, setting up a new unit for frail and elderly patients coming into A&E who may need specialist but not emergency treatment.
It is thought only about a dozen hospitals in the country have hit their A&E waiting targets.
A&E attendances have risen by 50% over the past decade and the Care Quality Commission has already said it believes the rise in demand for A&E is unsustainable. NHS Confederation chief executive Mike Farrar has said the A&E service is on a "cliff edge".
And the College of Emergency Medicine has raised concerns over the "rising demands" being placed on A&E departments.
Ms Prescott said the fine had been reinvested back into the hospital to help it improve.
She said: "For the staff, missing the target by such a small percentage can feel a bit demoralising because they work hard every day.
"For the first six months of the last financial year we did achieve this standard and we have been doing a lot of work around redesigning the process in the emergency department and elsewhere in the hospital.
"People think this is about waiting times but it actually measures the time of arrival to a patient being treated and either sent home, transferred to a community hospital or other care service, or admitted to the hospital itself – all in four hours.
"But we have some very positive feedback about the work we do and are continuing to do."
In the year to April, the RDH dealt with 119,140 patients at A&E, with 7,238 being seen after four hours.
When the Department for Health was asked last night how many hospital trusts had achieved their A&E target, it could not give the information.
In January, the RDH had to cancel operations and open extra rooms to cope with a huge increase in patients.
In October, the hospital announced it was opening a new "walking wounded" centre which aims to take pressure off the A&E department.
In August 2010, a senior consultant said more staff were needed in the casualty department. In October 2009, the hospital cancelled operations and opened extra beds as swine flu pushed up patient numbers.
In December 2008, when A&E was still based at the Derbyshire Royal Infirmary, hospital chiefs said they had seen a 50% rise in the number of patients needing to be admitted to A&E overnight.
