Full extent of winter NHS crisis revealed as Norfolk hospitals hit ‘safe’ occupancy levels just three times

PUBLISHED: 16:00 24 March 2018 | UPDATED: 16:17 24 March 2018

A line of ambulances waiting outside the A&E Department at the Queen Elizabeth Hospital in King's Lynn. Picture: Ian Burt

A line of ambulances waiting outside the A&E Department at the Queen Elizabeth Hospital in King's Lynn. Picture: Ian Burt

Archant 2018

The full extent of winter NHS crisis has been revealed as figures showed Norfolk hospitals hit ‘safe’ occupancy levels just three times.

Ambulances queuing at the Norfolk and Norwich University Hospital A&E department. in December. Picture: ANTONY KELLYAmbulances queuing at the Norfolk and Norwich University Hospital A&E department. in December. Picture: ANTONY KELLY

Between November 20 and March 4 hospitals had to report how they were performing to the NHS every day - with data published weekly - to keep an eye on the impact on winter.

The reports revealed how thousands of patients waited more than an hour to be transferred from an ambulance to hospital and the extent to which hospitals were full.

On average, wards at Gorleston’s James Paget University Hospital were 99.1pc full this winter, followed by the Queen Elizabeth Hospital in King’s Lynn which was 98pc full - while the Norfolk and Norwich University Hospital (NNUH) had an average of 95pc.

This was well above the recommended safe limit of 85pc and between them the three hospitals only dropped below that level on three days.

The NNUH operated over the safe limit for the whole period and was full for three days - but it had the most arrivals by ambulance at 13,567.

But the JPUH was completely full for more than half the winter (53 days out of 104).

The QEH was full for five days. Both smaller hospitals had more than 6,000 ambulance arrivals.

In hospitals where more than 85pc of beds are occupied, there is a greater risk of patients receiving inadequate care, being placed on an inappropriate ward for their condition, or contracting superbugs such as MRSA, according to the British Medical Association.

And Chris Hopson, chief executive of the organisation NHS Providers, said: “There is strong evidence that bed occupancy rates above 85pc can compromise patient safety, increasing the risk of infection.”

Patients also faced problems before they got into hospitals - 2,443 people had to wait more than an hour to be transferred from and ambulance into A&E because departments were so busy.

Some 4,133 people waited between 30 and 60 minutes.

In periods of particularly intense pressure, hospitals are forced to use temporary escalation beds. These are sometimes placed in areas not usually used for hospital patients, such as gyms or day care centres.

On February 19 at the NNUH, there were 73 escalation beds in use, which was the highest figure recorded during the reporting period. The highest number of escalation beds used at the QEH was 50, on the same day, and at the JPUH there were 52 open on January 2.

What’s happening now?

Since the winter period, plans have been put in place at all hospitals - including an immediate handover procedure at the NNUH.

Richard Parker, the hospital’s chief operating officer, said demand was easing and the handover system was “working well”. He said: “We have worked hard throughout the winter period to make the best use of our resources, including bed capacity. We’d like to thank our teams for their hard work and dedication over the winter. During periods of extreme levels of demand for our services, they have provided excellent care for the people of Norfolk.”

At the QEH and JPUH demand remained high. Graham Wilde, JPUH chief operating officer, said: “We have faced a sustained period of high demand for much of this month, which has put intense pressure on our bed capacity.”

Chief executive at QEH, Jon Green, added: “The winter period has been challenging across the NHS and we continue to be extremely busy.”

All three thanked staff for their “exceptional” work.

Can we trust the data?

Last month, this newspaper noticed inaccuracies in winter data provided to NHS Digital by the NNUH - but when we told officials and provided them with correct data, they refused to update their records.

Between December 26 and January 21, figures showed there were no delays in handing patients at the hospital, despite long waits being reported.

The NNUH said because of a change in how the ambulance service measured its response times in October, and the data “could not be verified”.

But other Norfolk hospitals reported their statistics and it took four days after we contacted the hospital about the discrepancies to be provided with the correct data.

Our journalists reported the inaccuracies to NHS Digital. But the authority refused to update their records. A spokesman said: “The figures published are management data which has been collected on a rapid turn-round basis. The speed of the collection only permits minimal validation to be undertaken but the data is considered fit-for-purpose. For these reasons it is impractical to amend the published data to retrospectively correct any errors in submission that come to light.”

• The graphic above has been updated with the figures which have now been provided to us by the EEAST showing the true extent of ambulance handover delays.

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