Trusts across the country are struggling to meet demand. A common theme is a shortage of beds, requiring people to wait in the emergency department for long periods of time before being admitted to a ward, and a shortage of staff which has caused two trusts to close their Minor Injury Units so that staff can be transferred to A&E.
A shortage of a safe number of staff is resulting in trusts breaching the government’s agency pay limit and potentially harming their finances, and it means that one trust is considering closing A&E at one hospital. Shortage of staff and beds are also causing delays in elective care, and in one part of the country one service has effectively been privatised because there is no capacity for new NHS patients and instead they are being sent to a private hospital.
A&E waiting times
- Board papers at Warrington and Halton Hospitals NHS Foundation Trust show that on average for the last year more than ten percent of people waited more than four hours in A&E. In response the trust will create “extra roles of ‘nurse commander’ and ‘doctor commander’ for the A&E department”.
- The Royal Cornwall Hospital was put on Black Alert on Tuesday. The report said that 45 percent of hospital beds were occupied by people with dementia, and there were difficulties recruiting staff. St Mary’s Hospital on the Isle of Wight was put on Black Alert nine times in March, while on Tuesday Derriford Hospital in Plymouth was put on Black Alert “after unprecedented numbers reported to A&E”.
- On Tuesday Blackpool Victoria Hospital said that “patients [are] being seen in the corridor” and that “a ‘corridor nurse’ was introduced to ease ‘pressures’ on the emergency department and to help reduce the amount of time it takes to handover patients from paramedics to casualty staff.”
- Princess Alexandra Hospital in Harlow temporarily closed its minor injuries unit on Tuesday. This was attributed to “high demand” in the A&E department.
- In Lancashire the Accrington Victoria Community Hospital Minor Injuries Unit was closed temporarily so that staff could me moved to the emergency department and urgent care centres at Royal Blackburn Hospital and Burnley General Hospital because they were “experiencing exceptionally high demand for services”.
- Basildon Hospital reported that in February one in five people attending A&E had to wait more than four hours. “The trust’s bed occupancy rate remains very high, at or above 100 per cent, and the trust has remained on black alert for a significant proportion of the last two months.”
- George Eliot Hospital in Nuneaton reported that this year is bringing a “15 per cent increase in the amount of patients into Accident and Emergency, a 20 per cent rise in ambulance admissions and the junior doctor’s strike, the hospital is almost at crisis point”. Walsgrave Hospital in Coventry saw more than 600 people in its emergency department on Monday.
- Wythenshawe Hospital in Manchester declared a “major internal incident” because of “increasing demand on its A&E unit and a shortage of beds”.
- In Kent, Medway Maritime Hospital was so full that a woman in her 80s was left in an A&E corridor for 13 hours because there were no free beds on the wards. Her daughter, Ann Fowler, said: “I can’t fault the staff – they were so supportive but totally overwhelmed. A nurse told me they had 500 patients in 12 hours.”
- The Northern Devon NHS Trust board reported that the Trust “could be facing a shortfall of £442 million by 2020 if nothing changes in the way services are delivered”. Region organiser for the GMB, Lisa Ryan, said that paramedics “are now at breaking point; increasingly frustrated, hanging around hospital corridors knowing that patients in the community are waiting for their help”.
- A GP in Durham said that “we have every day an unachievable workload we cannot safely do”. He said that “the Government’s agenda was privatisation – ‘either that or they are utterly incompetent’ – and funding for primary care within the NHS was ‘paltry’.”
- A parliamentary question resulted in the government admitting that the repairs and maintenance bill for London hospitals has reached £1.2 billion. This includes nearly £145 million for urgent high-risk repairs that may be needed to prevent a “catastrophic failure”.
- On Thursday at the hospital board Basildon Hospital said that the Trust had borrowed £44.7 million last year and needed £31.1 million of new loans this year.
- East Midlands Ambulance Service has a deficit of £12 million and “has had to apply for a loan because of the debt it is facing”. The Trust was fined more than £17 million over a four month period for missing targets.
- Bradford District Care NHS Foundation Trust has breached, on safety grounds, the new limits on pay for agency doctors and nurses. Sandra Knight, director of human resources and organisation development, said: “In December there were 68 clinical shifts out of 333 shifts that were filled by 18 individuals who were paid above the price cap”.
- Campaigners say they are “appalled” at a decision to approve initial plans for the closure of one of Shropshire’s A&E departments. The medical director of Shrewsbury and Telford Hospitals NHS Trust, Edwin Borman, said “We can’t sustain two A&E departments currently due to being unable to attract the workforce we need”.
- Parents in Chester have set up a petition in objection to the decision of the West Cheshire CCG to “stop [the] funding that enabled children to receive hospital care at home”.
The hospital transport service in Sussex was taken over by private company Coperforma at the beginning of the month. The service has started badly: “the company has been forced to apologise after patients – some of whom live alone – have been left at their homes and cannot get to hospital for treatment”.
Treatment waiting times
A man has had his operation cancelled for a second time at Cumberland Infirmary in Carlisle because the hospital had no free beds. “I sat for four hours in the waiting room. After that the surgeon himself came to see me. There was a cardiologist on standby and they were both ready to go, but there were no beds.”
Spinal patients in Plymouth will now have to travel to a private hospital in Salisbury for treatment “after Plymouth’s Derriford Hospital refused to accept new routine cases because of sky high demand”. The next closest NHS neurosurgery centre is at Southmead Hospital in Bristol but two months ago it also stopped taking on new patients for routine spinal surgery.