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Southport Reporter®

Edition No. 105

Date:- 28 June 2003

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ALMOST a quarter of construction sites visited by Health and Safety Executive inspectors during a national blitz on falls from height stopped the operation of construction sites during the month of June. 

Inspectors visited 1446 construction sites across Great Britain to make sure that where work at height was taking place or planned, the risk of falling was being properly managed. Falls from height remain the single biggest cause of death, disability and injury in construction in Great Britain, accounting for 37 deaths and 1344 major injuries of workers in 2001/2. Twelve construction workers have died from fall from height accidents since the beginning of April this year.

Startlingly, another five per cent of the sites visited were issued with improvement notices and a number of dutyholders are still being considered for possible prosecution. There were also many instances of work voluntarily stopping until easily solved fall from height risks were reduced.

Kevin Myers, Chief Inspector for Construction said:- "It was good to see during the inspection blitz that many people were aware of the campaign and many people had also taken action to improve work at height practices. 

Yet despite the industry knowing that HSE inspectors were out in force specifically looking at falls from height the standards on 30 per cent of the sites visited were so poor they required enforcement action. This evidence suggests that there is still a large number of people working in the construction industry that are either not aware or do not fully understand their duties to manage fall from height risks. This situation must change if we are to reduce the rate of falls from height, which remains the biggest
cause of death or injury in construction."

Although sites were predominately found to be relying on traditional scaffold, harnesses or mobile towers there was evidence of increased use of Mobile Elevated Work Platforms, nets and airbags. However some problems were identified with the installation of nets that were not being secured to suitable anchorage points.

Other problem areas identified by inspectors related to poor compliance with the Construction (Design and Management) Regulations 1994 (CDM Regs). In some instances contractors and planning supervisors were found to be either not fulfilling or not aware of their duties.

The blitz was part of 'Don't Fall For It', a Europe-wide inspection-led campaign to reduce falls from height in construction. For the first time, the blitz involved the co-ordinated action of all frontline construction inspectors in Great Britain during the two weeks. The European Commission's Senior Labour Inspectors' Committee agreed to undertake this campaign on falls from height risks in the construction industry in 2003, supported by the European Agency for Safety and Health at Work. The campaign features two inspection initiatives, the second will be taking place in September. All member states will be participating in the campaign.

Questions & Answers
Report by Nicky Williams of Health Start.

HERE are the following concerns regarding the move of Women's and Children's Service, which have been answered by the Trust's Chief Executive, Jonathan Parry and Medical Director, Ian Harrison:-

Part a - Background to the move

Q. Why change clinical services at Southport and Ormskirk?

A. Ten years ago, managers and clinicians from the then separate hospitals in Southport and Ormskirk met to discuss the difficulties they were experiencing in providing clinical services from two small DGH's. By 1999 there had been two public consultations in an attempt to reorganise clinical services to resolve pressures. No agreement could be reached, so in 1999 the Secretary of State for Health commissioned Professor Sir Robert Shields to recommend arrangements for the reconfiguration of services at Southport & Formby DGH and Ormskirk DGH. His main recommendations were; to have outpatients and diagnostic services on both sites; major and emergency surgical inpatient services concentrated at Southport; women's and children's inpatient services concentrated at Ormskirk. The Minister for Health accepted his recommendations as status quo was not an option in 1999.

Q. Couldn't it have been prevented?

A. No, these changes were essential and were proposed by doctors and nurses who first recognised the impossibility of continuing to duplicate services at both sites. There was a growing need to relieve the pressures of junior doctors' hours and the need to provide greater levels of specialist care and high quality services, which could not have been achieved across two small sites. If women's and children's services had not moved to Ormskirk, they might have had to look at the closure of these services and people would have had to travel to Liverpool.

Q. It's all being driven by money, isn't it?

A. No, it's actually costing more money to implement the changes to provide local care that is safe, of better quality, effective and accessible.

Q. Why move services early when the new building at Ormskirk has not been finished?

A. The clinicians urged us to make the move earlier than planned because they felt they couldn't carry on running services from two hospitals. Requirements to comply with junior doctors' hours' legislation also influenced the decision to move early. Until the building is occupied in December 2004, patients will be treated in upgraded existing facilities and purpose-built additional units. Senior Clinicians and Nursing staff are already seeing the benefits in terms of improved staffing levels as a result of centralising the services.

Q. Will services change back to Southport?

A. We needed to make the changes in accordance with NHS modernisation. We would not justify reverting back to 

a system that didn't work and would be unsafe. The status Quo was not an option.

Q. Will there be a separate A&E unit for children when the buildings are occupied?

A. Yes, children will have their own A&E facility separate geographically from adults. Children should not be treated in an adult A&E because it is not always a nice environment for children. The new facility will provide a child-friendly environment and will be safer. It will be staffed by Paediatric trained Doctors and Nurses and led by a Consultant in Paediatric A&E.

Q. Why choose Ormskirk to have women and children's services when Southport has lots of mums and children too?

A. According to the Shields report, Ormskirk was the preferred site because, statistically, West Lancashire has more young mothers and children than Southport.

Part B - Addressing parents' concerns

Q. What do I do if my child is ill and in severe pain?

A. Take your child to the nearest A&E for children, which are at Ormskirk Hospital, where the appropriate quality of care will be given by Paediatric qualified staff.

Q. If my child is seriously ill; shouldn't I go to the nearest A&E? What if I called an ambulance for my child?

A. The nearest Paediatric inpatient and Accident & Emergency Services are concentrated at Ormskirk Hospital, where parents should take their children in order to be treated in the right place at the right time by appropriately trained staff. 
If you call an ambulance your child will be transported to the A&E Department at Ormskirk District General Hospital. However, if the Paramedic Team believes that the child's life is in immediate danger and unable to make the journey to Ormskirk, a protocol has been agreed with the Ambulance Service whereby the patient will be taken to the nearest hospital with A&E services, which in some cases may be Southport. Here the patient would be resuscitated and stabilised, prior to going on t
o the Paediatric Unit.

Q. but why should I travel to Ormskirk when I live outside Southport Hospital, which has an A&E?

A. Because Ormskirk Hospital is where all the experienced, Paediatric qualified doctors and nurses are based, who will be able to provide your child with the best possible care.

Q. Why can't there be some sort of children's facility at Southport?

A. It has been recognised that it was not possible to duplicate services on two sites, which is why we have concentrated children's services at Ormskirk. Children's services were becoming untenable with closure of the Children's Ward on one site at weekends. Covering two sites with one Consultant on-call is unsustainable.

Q. What if I go to Southport with my child?

A. The correct place to go is Ormskirk. If somebody mistakenly went to Southport, the child would be assessed by a nurse and, depending on the condition, would be referred to Ormskirk.

Q. How can Southport Hospital turn children away?

A. No child has - or ever would be - turned away from Southport. In every case the child has been assessed by a qualified, experienced nurse. The parent or parents are reassured and advised to attend Ormskirk, where there is 24-hour cover by paediatric staff and qualified children's nurses. If a child were in a critical condition, that child would be stabilised at Southport before being transferred to Ormskirk.

Q. Why was I told I would have to go to Alder Hey for treatment when I followed the correct procedure and took my child to Ormskirk?

A. In some circumstances, the Trust may not have the specialist staff to administer the appropriate care, as has always been the case. In such cases, the parent or parents would be advised to take their child to Alder Hey, where the right care can be given and a nurse would check that they are able to travel to Liverpool.

Q. What happens if I am injured in an RTA with my child?

A. The same as happens now, patients are taken to the nearest suitable trauma unit, which could be in separate hospitals.

Q. What if something happens to my child during the journey to Ormskirk?

A. As in all emergencies, dial 999 for an ambulance. Emergency care is delivered initially by paramedical services, who would then take the child to the nearest appropriate A&E.

Q. Shouldn't there have been better transport links in place before the services moved to Ormskirk?

A. I accept that better transport links are needed. The Trust is working closely with the local authorities and transport service providers to improve transport links. A large number of patients attend outpatient clinics only, these services are provided at both sites. Physiotherapy, X-Ray examinations and arrangements for blood tests will be at both sites. Travelling will be kept to a minimum. But, if we had waited for transport links to be resolved services may have become unsafe and some services lost to Aintree or Royal Liverpool for example. We would urge local politicians in Sefton and West Lancashire to lead the demand for local improvements.

Q. Can I claim for travelling expenses?

A. the Government provides a scheme where people with low incomes can reclaim the costs of their journeys to hospital.

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