A Norfolk hospital has delivered more than 11,000 vaccinations since December - but warns there are stark challenges ahead as Covid admissions continue to surge.
At a James Paget Hospital board of directors' meeting on January 28, chief executive Anna Hills revealed Covid-19 inpatient numbers are now double those of April, with December-January recording a "massive increase".
On the plus side, she explained the vaccine rollout was "going a long way in protecting the community" - with 90pc of the JPH workforce now vaccinated.
But uncertainties about infection control within the hospital remain a sticking point.
Paul Morris, director of nursing, said an important method of keeping infection numbers down was reducing the amount of patient transfers.
He said: "We know that the number of times patients are moved is not great for their experience, or from an infection control point of view.
"It's not good to have patients moving around the facility, but they are normally moved to meet clinical demand or meet the needs of a ward as a whole."
He added that staffing levels were having a direct impact on patient care - with many members off due to sickness or shielding.
"Our normal nurse to patient ratio is 1:8, but has been getting to 1:10, 12 or even 14", he said.
"Never before have our staff had to work in such difficult circumstances, but at all times they strive to provide the highest quality care."
Workforce lead Graeme Armitage said that nine JPH nurses had been sent to help the Norfolk and Norwich University Hospital deal with the surge there.
He reflected that "none of us could have known April was just the warm-up act".
Karen Hensed, director of governance, then put forward the main health and safety issues the trust needed to work on - stressing that reducing delays in responding to complaints was paramount.
Other "concerns" she raised were the "higher than expected" numbers of external serious incidents and inpatient falls with harm.
Her report, presented to directors, revealed that there had been 25 harmful falls among inpatients in December as well as 19 'serious incidents'.
These, she said, related mainly to infection control breaches and patients waiting longer than 12 hours to be seen at A&E.
The report said that 33 patients in total waited longer than 12 hours in the emergency department in December, and that there were 727 ambulance handover delays of 30 minutes or more.
Meanwhile, the amount of people starting treatment within 18 weeks of referral was running at 63.81pc at the end of December - down from the target of 92pc.
She did, however, say that no harm had been reported by patients facing operation delays, and that urgent cancer treatments were still going ahead.
A further point raised by Ms Segasby related to the number of patients still in the hospital who didn't need to be.
"We need to improve the flow of patients out of the hospital", she said.
"We now have two facilities for Covid-positive patients to be discharged to - one in Norfolk and one in Suffolk.
"In the autumn we had 100 patients ready for discharge, which means around a quarter of our total patients could have continued their care elsewhere.
"Now that figure is down to 60-70".
She explained that social care settings were facing the same issues as hospitals, and that they only had a "finite number of beds" for discharged hospital patients.
On top of this, Ms Segasby added that the demands of patients "change a lot" - which means the number of people eligible for discharge fluctuates.
"Yesterday, for example, 50pc of our A&E attendees came by ambulance", she said. "Naturally, their stay with the hospital will be longer."
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