Why is the Norfolk and Norwich Hospital the worst performing in the country for A&E waits and what is being done about it?

Eastern Daily Press: How the new 70-bed ward block at the NNUH should look when it opens in March. Photo: NNUHHow the new 70-bed ward block at the NNUH should look when it opens in March. Photo: NNUH (Image: NNUH)

The Norfolk and Norwich Hospital's hopes of recovering from its worst ever A&E waiting times lie in a car park outside its east block.

Here it is opening a new three-storey ward with 70 beds in March to ease the strain on its emergency department.

It is the first time since the NNUH opened two decades ago that it has significantly expanded, despite demand increasing massively in that time.

The number of people visiting the emergency department has gone up by a third since 2014 from 111,000 to 148,000.

Eastern Daily Press: Lacey Taylor was taken to the NNUH's A&E by her mum on Saturday December 21. Her mum said there were no seats left in the children's waiting area so her daughter slept on the corridor floor for around an hour before getting a bed. Photo: Carla TaylorLacey Taylor was taken to the NNUH's A&E by her mum on Saturday December 21. Her mum said there were no seats left in the children's waiting area so her daughter slept on the corridor floor for around an hour before getting a bed. Photo: Carla Taylor (Image: Carla Taylor)

NHS chiefs rightly point to rising patient numbers as a reason for the hospital struggling, but even when it was being built there were warnings it was not going to be big enough.

The then Norwich North MP Ian Gibson said in 1999 that the hospital would need an extra ward to deal with rising demand.

His prediction came true and in 2018 then NNUH chief executive Mark Davies said: "This hospital ain't big enough."

In December the NNUH posted its worst ever results for the percentage of patients arriving at A&E being treated within four hours.

Eastern Daily Press: The front page of the Norwich Evening News in January 1999 warning that the NNUH was not big enough. Photo: ArchantThe front page of the Norwich Evening News in January 1999 warning that the NNUH was not big enough. Photo: Archant (Image: Archant)

Just 55pc of patients were seen within the target, making it the worst performing in the country; the national average was 80pc.

Norwich North MP Chloe Smith said she would be asking the health secretary for money to upgrade A&E "as soon as possible".

That cannot come soon enough for patients.

This newspaper published a photo on Friday of Lacey Turner, 11, sleeping on the floor of a corridor because the children's emergency department was so full.

In response, NNUH chief executive Sam Higginson said: "Our staff are working really hard to assess and treat patients as quickly as possible to provide safe and appropriate care."

He added said the hospital was taking action such as opening escalation beds and increasing staffing levels.

-What is being done?

Eastern Daily Press: Chloe Smith says she will ask health secretary Matt Hancock for more funds for the NNUH's A&E after its latest poor waiting time figures. Photo: NNUHChloe Smith says she will ask health secretary Matt Hancock for more funds for the NNUH's A&E after its latest poor waiting time figures. Photo: NNUH (Image: NNUH)

Local NHS commissioners said they invested £4.5m this winter to increase capacity in Norfolk and Waveney's health services.

That included:

-More than 2000 weekend and evening GP and nurse appointments a week.

-Increased therapy services at Norfolk's three hospitals to get patients home quicker.

Eastern Daily Press: Vicky Fraser, from West Earlham, said she had a positive experience at the NNUH A&E. Picture: Vicky FraserVicky Fraser, from West Earlham, said she had a positive experience at the NNUH A&E. Picture: Vicky Fraser (Image: Vicky Fraser)

-More than 100 additional beds at all three hospitals in Norfolk and Waveney to increase capacity.

-Are we getting a bad deal?

The amount of money given to commissioners to pay for NHS services in Norfolk and Waveney works out at £1,343 per person this year; that is almost the same as the average in England.

But Norwich and South Norfolk - the two main areas the NNUH serves - get among the lowest amount in the country with £1,179 in Norwich and £1,207 in South Norfolk per patient. Great Yarmouth receives the most in the area at £1,450.

By November 2019 the NNUH was already £20m in the red for this financial year and it is having to make savings of £26m.

It is also hampered by a burden to pay the firm which built it millions of pounds every year under a deal called a Private Finance Initiative.

It owes £190m to Octagon Healthcare Ltd for building it - a deal previously described by Norwich South MP Clive Lewis as "the worst credit card on the comparison site".

Despite paying Octagon almost £60m a year, the NNUH is barely paying off the debt as so much of the money is taken up by interest.

Last year the hospital asked for help from the government to pay the money.

-What patients say

In a survey for this newspaper of more than 500 people around half of patients said they were "very happy" with the service they got in Norfolk's emergency departments, despite the long waits.

Sara Gardiner, 35, from Costessey, who went to the NNUH's A&E on Friday August 2, described the care as "amazing".

Jane Diya, 36, from Dereham, said she visited the hospital at the end of November with abdominal pain.

"There were people waiting in corridors waiting to be seen, they were so overstretched," she said.

Elizabeth Knight, 54, Dereham, visited A&E in December with joint pain.

"We got there at 9am and we only waited about five minutes to see the first nurse. She was really caring and lovely," she said.

Vicky Fraser, 66, from West Earlham attended A&E on December 7 with chest pains and was seen with an hour.

"People do wait a long time but if there's anything seriously wrong with you they will sort it," she said.

"Too many people go to A&E for things they don't need to," she added.

-What the politicians say

Norwich South Labour MP Clive Lewis said the prime minister was in "deep denial" about the crisis in the NHS.

"Here we are almost ten years into Conservative government and we've still got these horrendous things happening at our county's major hospital," he said.

"People are sick and tired of broken pledges, continual promises of jam tomorrow and passing the buck.

"The Tories have got the majority they say they needed to get Brexit done and move onto fixing our NHS. Local people will remember that."

Conservative Norwich North MP Chloe Smith said she was "really concerned" by the A&E waiting time figures.

"It's not good enough for patients to wait like this, despite the hard work of fantastic staff," she said.

"That's why the government is already investing a record amount into the NHS and we will see the benefit locally with a new ward being built and a new diagnostic centre helping find cancers sooner."

-James Paget bucks trend

While the A&E waiting times at the Queen Elizabeth Hospital in King's Lynn and the NNUH worsened in December, the James Paget in Gorleston improved last month with 84pc of patients seen within four hours.

It was the only hospital in the region to beat the national average of 80pc.

"We plan extensively for the busy winter period, using experience of previous years to inform our work," a spokesman said.

"We are continually looking at ways of increasing capacity by ensuring that patients are seen by the right people at the right time in the right place and that we have the processes in place so patients can be discharged as soon as possible."

The hospital has put in extra staff to help patients who come to A&E but don't need emergency treatment.

Chief executive Anna Hills said: "Once again, our staff have gone above and beyond to care for patients while displaying exceptional teamwork. I would like to thank them for their efforts."