Dozens of patients treated in corridors, 40-hour A&E waits and warnings to think twice about calling 999: Why IS the NHS struggling and is YOUR hospital affected?
- The health service is currently besieged by a tide of post-Christmas demand
- Several trusts have issued appeals for public not to call 999 unless life is in peril
- Others have banned visitors or begged family members to come pick up patients
Dozens of patients being cared for in corridors, and some patients forced to wait 40 hours in A&E, with more NHS hospitals declaring critical incidents.
The health service in England is currently besieged by a tide of post-Christmas demand with medics and paramedics swamped by people becoming severely ill with winter bugs.
Several hospitals and ambulances have issued appeals to the public to stay away and not call 999 unless their life is in peril, while some have warned that elective procedures are ‘under review’.
Others have banned visitors or begged family members to come pick up patients who are well enough to leave hospital to care for them at home.
Nottingham University Hospitals have begged family members of patients who are well enough to leave but stuck in hospital to come collect them to help free beds for others
In the North East, a patient at York and Scarborough Teaching Hospitals NHS Foundation Trust was forced to wait 40 hours in A&E. Pictured: York Hospital
University Hospitals Dorset NHS Foundation Trust (pictured) was among those that have declared a critical incident. The Trust said it was currently fighting a losing battle: ‘The number of admissions is exceeding the number of patients being discharged.
Fresh NHS data shows that handover delays reached at an all-time high in the week to Christmas. More than 3,000 paramedic crews spent at least one hour waiting outside of hospitals on December 19 before they could hand over their patient to emergency department medics. The figure is the highest recorded this winter
Critical incidents: This is where the level of disruption results in the organisation losing its ability to deliver services, resulting in patients potentially being been harmed or at risk. It allows an body to seek support from other health operators.
NHS bodies to declare critical incidents so far:
South Western Ambulance Service
North East Ambulance Service
Gloucestershire Royal Hospital
Surrey and Sussex Healthcare NHS Trust
Business Continuity Incidents, where service disruption is occurring due to demand:
NHS bodies to declare Business Continuity Incidents so far:
East of England Ambulance Service
Other NHS trusts have said they are ‘under pressure’:
Sandwell and West Birmingham NHS Trust
Royal Devon University Healthcare NHS Foundation Trust
In the North East, a patient at York and Scarborough Teaching Hospitals NHS Foundation Trust was forced to wait 40 hours in A&E.
The Trust revealed the grim figure in a message circulated to staff yesterday.
This communication also said that ‘many many’ ambulances were stuck in queues outside the hospital in York due to a lack of beds to unload patients, an issue that has plagued the NHS this year.
The Trust said nurse staffing was ‘challenging’ because so many were calling in sick. NHS England data today showed that an average of 63,000 staff were off work every day in the week to Christmas.
The Trust added it was asking staff well enough to work to pick up additional shifts to get more patients discharged out of the hospital, which would enable them to take on new arrivals.
It comes as fresh NHS data shows that handover delays reached at an all-time high in the week to Christmas.
More than 3,000 paramedic crews spent at least one hour waiting outside of hospitals on December 19 before they could hand over their patient to emergency department medics. The figure is the highest recorded this winter.
Ambulance handovers are supposed to take place in 15 minutes.
In the week to Christmas, a total of 13,932 ambulances spent longer than an hour outside of hospitals — the second highest logged this season.
Delays can occur due to A&E units being overwhelmed by a lot of ambulances at once, as well as a lack of beds.
Not all delays see patients stuck in the back of ambulances, some are left in hospital corridors.
These hospitals are not alone, with several more as well as three ambulance services in England warning they are under worrying levels of pressure, with some even going so far as to declare ‘critical incidents’.
This is an official warning from an NHS body that patient safety is being compromised by high levels of demand, enabling them to call upon other health bodies for help.
One doctor, who has spent over two decades working in the NHS, went so far as to call the current crisis a ‘national emergency’.
The unnamed medic told The Sun that pressure on the service was ‘beyond anything we can safely look after’.
‘We’ve got patients being looked after in corridors, patients in the corridors of each ward as well,’ he said.
‘The main issue is there are delays when people need to go into a ward — you can wait up to two days for a bed.’
He said he had recently seen 36 patients being treated in one corridor.
The NHS blames ongoing pressures in part on workforce shortages, with 130,000 vacancies across its entire workforce. On top of this, staff absences are on the rise.
It is also battling a ‘twindemic’ of flu and Covid, with 3,746 patients with influenza in hospital each day, on average, last week — up seven-fold in one month. Around 8,600 Covid patients were taking up beds on December 21, up 84 per cent on last month.
Some patients have been forced to spend both Christmas and Boxing Day in A&E due to extraordinary 20-hour waits to be seen, one medic has said. (image taken at The Royal London Hospital on December 21)
NHS England data today showed that an average of 63,000 staff were off work every day in the week to Christmas (red line). Around 8,000 of the absences were due to Covid (blue line)
A&E performance has worsened in November, with a third of emergency department attendees not seen within four hours (red line) — the NHS’s worst ever performance. Thousands weren’t even seen after waiting in casualty for 12 hours (yellow bars)
More than 7.2million patients in England were stuck in the backlog in October (red line)— or one in eight people. More than 400,000 have queued for at least one year (yellow bars)
Ambulances took an average of 48 minutes and eight seconds to respond to 372,326 category two calls, such as heart attacks, strokes burns and epilepsy (red bars). This is nearly three times as long as the 18 minute target but around 13 minutes speedier than one month earlier
Why IS the NHS struggling this winter?
Some 13,000 hospital beds across the country — or one in seven — are currently filled with patients declared fit for discharge.
The figure is triple the pre-pandemic average.
And there is huge variation across the country. In London, half of patients were discharged on time but the figure was as low as 28 per cent in the North West.
Experts say the numbers are being driven by a separate crisis in social care, leaving patients left to languish on wards for up to nine months because there is no suitable nursing accommodation or care available for them in the community.
The lack of beds has seen ambulances stuck in queues for 20 hours outside of hospitals this summer, as emergency medics scramble to find beds for patients. This is had a knock-on effect on response times.
The NHS, which employs over a million people, has around 130,000 vacancies across its entire workforce.
This reduces productivity, with too fewer staff to carry out appointments and procedures.
Health chiefs also warn that it stops staff from delivering high-quality care and can lead to safety concerns if too few staff are working.
In turn, medics are at a higher risk of burnout, illness and early retirement due to these factors.
Surge in seasonal viruses
More than 1,000 beds per day are taken up by patients severely unwell with seasonal viruses.
NHS data shows Britons sickened with influenza occupied 712 beds, on average, each day last week. Flu levels are much higher than this time last year.
Meanwhile, norovirus accounted for 318 taken beds per day and RSV saw 132 occupied.
Strep A fears
Nine children in the UK have died in recent weeks due to an outbreak of Strep A.
The bacterial infection is harmless for the vast majority. But it can cause life-threatening illness if the bacteria invade the blood, muscles or lungs.
Doctors have warned that A&E, GPs and ambulances are in meltdown due to a surge in demand from parents worried that their child is infected.
Patients have faced longer emergency department waits, while some hospitals have postponed routine procedures to cope with demand.
Around 4,700 beds per day were occupied by a patient infected with Covid in the week to November 30.
Two-thirds were primarily admitted for another ailment, such as a broken leg, but happened to test positive.
However, infected patients still pile pressure on the health service as they have to be isolated from others.
The virus also contributes to higher rates of staff sickness.
GP appointment crisis
Campaign groups, MPs and senior medics say desperate patients are turning to emergency and walk-in services because they can’t get a face-to-face appointment with their GP.
The average GP in England is responsible for 2,200 patients now – up from 1,900 in 2016.
In the areas with poorest access, up to 2,600 patients are fighting over one family doctor.
The Royal College of Emergency Medicine (RCEM) has previously warned difficulties in seeing a GP was leading to a crisis in emergency departments.
Further adding to the crisis is the fact that 12,000 hospital beds were taken up by bed-blockers in the last week.
Experts say the numbers are being driven by a separate crisis in social care, leaving patients left to languish on wards for months because there is no suitable nursing home accommodation or care available for them in the community.
Other NHS hospitals that have declared a critical incident included University Hospitals Dorset NHS Foundation Trust.
The Trust said it was currently fighting a losing battle: ‘The number of admissions is exceeding the number of patients being discharged.’
It added that while elective procedures like knee and hip operations were still being carried, this was under ‘constant review’.
Another critical incident was declared at Nottingham University Hospitals NHS Trust (NUH) yesterday, due to the number of people attending A&E with ‘respiratory conditions’.
Hospital bosses said they had 220 patients in their emergency department with 70 more waiting for a bed.
However, they added that the bed-blocking crisis was compounding the issue. Some 160 patients had been declared well enough to leave the hospital for 24 hours but couldn’t be discharged as there no-one in the community to take care of them.
NUH’s medical director Dr Keith Girling begged family members of patients stuck in hospital to come collect them to help free beds for others.
He said: ‘With the busy holiday period, often families aren’t ready or prepared for their loved one to come home and we are asking for their support to help our discharge teams get those patients who are medically fit back home as soon as possible.
‘There are some really simple things that can help, like collecting your relatives as soon as possible, setting up a bedroom in their home or going to their house to stock the fridge and pop the heating on.’
NHS Greater Manchester was one body that issued a plea for the public to only use emergency services in the direst of circumstances yesterday.
Writing on social media they said: ‘The first day back after the Christmas break is always busy for NHS services — today has been beyond anything we have experienced before.’
‘We’re making an urgent plea to the public in Greater Manchester to only call 999 or attend A&E if their condition is a life-threatening emergency.
Other hospitals that have declared critical incidents so far this week include Gloucestershire Royal Hospital and Surrey and Sussex Healthcare NHS Trust.
Two ambulances services, South Western Ambulance Service and North East Ambulance Service, have also warned they are in a critical incident.
The East of England Ambulance Service has also issued a Business Continuity Incident, which is a warning that services are under pressure due to demand.
Other NHS trusts have also warned they are ‘under pressure’ but are yet to declare any official kind of incident.
These include Sandwell and West Birmingham NHS Trust and Royal Devon University Healthcare NHS Foundation Trust.
And a hospital in Cornwall yesterday urged people heading to the region for New Year to bring their own medications such as pain relief and rehydration powders.
Royal Cornwall Hospitals NHS Trust, which has urged people to only call 999 or use the emergency department for life-threatening illnesses and injuries, tweeted the advice ahead of the upcoming celebrations.
It said: ‘Heading to Cornwall this New Year? Just in case, be wise and bring these three self-care kings! Pain relief, flu and cold remedy and rehydration powders. And don’t forget to pack any prescription medicines, too. Help Us Help You.’
The trust attached an image detailing what people should have in a first aid kit, including bandages, dressings, tweezers, scissors, antiseptic and medical tape.
Other NHS bodies have taken more drastic measures due to the surge in winter demands.
Two hospitals have now banned most visitors and instructed patients to wear masks on its wards after being ravaged by a swath of winter bugs and Covid.
The move was enacted jointly by NHS Northampton General Hospital and Kettering General Hospital Trusts yesterday.
However, hospital bosses say the move is needed to protect vulnerable patients on the wards from a ‘significant increase’ in Covid, flu, RSV, and norovirus infections.
But the decision prompted fury from one Tory MP who called said ‘locking’ patients away from their loved ones was ‘wrong and cruel’.
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