‘There are no easy solutions’ - Norfolk and Norwich University Hospital under strain as patient numbers soar
- Credit: copyright: Archant 2014
The woman at the helm of Norfolk's largest hospital has admitted the trust cannot do all it wants to help patients, as A&E admissions have soared.
In a candid interview, Anna Dugdale said bed shortages at the Norfolk and Norwich University Hospital (NNUH) had forced the use of makeshift wards.
She said she would not want this manner of care for her own mother, but that it was preferable to the alternative of turning patients away.
Problems stem from the fact the region has a growing, ageing population and patients are staying in hospital for longer.
Coupled with a rise in A&E admissions - which have increased from 54,000 in 2008-09 to 68,000 this year - staff have been placed under immense pressure.
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'We are not able to do everything we would like to do for every patient at the moment, and that makes me very sad,' said Ms Dugdale, who has been chief executive of the hospital since 2008. 'We never shut our front doors.
'Our ability to accomodate all our patients depends on how many people turn up and how many people we can get out of the back doors.'
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She said there were 'all sorts of options', but she would never want to turn patients away.
The high level of demand for care has forced the use of non-ward areas for bed space - including makeshift wards in the medical school.
And some operations have had to be cancelled due to the volume of new admissions.
It is a situation brought about by rising patient numbers, and has placed staff under 'extreme' pressure - with a rise in nursing staff on sickness due to stress.
'I wouldn't choose this for my mum, but I wouldn't want her in the car park,' said Ms Dugdale. 'I would want her in the hospital.
'It's really tough for everybody.
'I do this job as I'm proud of what we do and I love it.'
She said it was not within the hospital's gift to solve the situation, and it required help from the wider healthcare community - to provide care at home and rehabilitation beds away from the hospital so beds could be freed up.
Asked whether the situation has reached a crisis point, she said: 'Our bread and butter is dealing with crisis, so I would never say that, as that's what our clinicians are trained to deal with.
'But the pressure that the emergency teams are under does take its toll day in day out.
'It's hard, physically and emotionally.
'I'm always full of admiration for them.'
And she agreed: 'Absolutely something does need to be done now.'
A report, which went before the NNUH trust board yesterday, revealed the A&E four-hour target had been missed on a number of occasions and two patients had to wait more than 12 hours in A&E.
She explained that those two cases involved 'patients with complex needs'.
The NNUH would not be recruiting more A&E staff, she furthered, as the problem was not with capacity at A&E, but with the time it took to discharge patients - with patients going through A&E to be met by a bed shortage further on.
'It's a complex situation and what we've seen is people reduce the headroom,' said Ms Dugdale. 'It just makes it really difficult to cope with.'
The number of A&E admissions has risen by 3.5% from April to August in 2013 to the same period this year.
'The scale of the operational challenge is being felt throughout the hospital across clinical and administrative areas and most particularly among staff involved in the care of emergency patients,' the boar dreport read. 'Sickness due to stress is high and the general level of sickness across the trust is up.'
Ms Dugdale explained that stress had been compounded as A&E admissions had risen at the time of some ward moves - during a re-decoration programme to maintain standards.
She said she did not know how long it would take to bring the 'extreme' pressure under control, but that dedicated staff were doing all they could.