Why our hospitals are feeling the strain of winter pressures

PUBLISHED: 08:54 07 January 2015 | UPDATED: 08:54 07 January 2015

Doctors and nurses at the Norfolk and Norwich University Hospital. Photo: James Bass.

Doctors and nurses at the Norfolk and Norwich University Hospital. Photo: James Bass.

Archant Norfolk Photographic © 2009

With lengthening A&E waiting times and hospitals full to capacity, winter pressures are affecting our region.

What is a black alert or internal major incident?

Black alert means a hospital is fairly full and new admissions are closely reviewed while every effort is made to discharge patients safely and quickly. An “internal major incident” is a step beyond, and could mean cancelling routine surgery and redeploying staff to other wards.

New NHS England statistics show the Christmas period was a tough one for our hospitals with just one A&E department in our region hitting the target of seeing 95 per cent of patients within four hours.

The Norfolk and Norwich University Hospital declared an “internal major incident” on Monday afternoon, which was expected to last throughout most of yesterday and possibly into this morning.

The Queen Elizabeth Hospital in King’s Lynn, meanwhile, has been on “black alert” since the weekend.

At the N&N, the latest internal major incident means it has had to cancel a lot of elective surgery, while still treating the most urgent cancer and emergency cases.

Latest A&E waiting times

One of the four A&E departments at hospitals in the region saw 95pc of patients within the target four hours.

The James Paget University Hospital in Gorleston saw 96.3pc of patients within target for the week ending December 28.

The N&N saw 86pc of patients in that time. The figure for the Queen Elizabeth Hospital in King’s Lynn was 89.9pc, while the West Suffolk Hospital saw 82pc.

Staff have also been redeployed to help out on busy wards and consultants from relevant specialities have been called away from normal duties to see patients in A&E to help speed up diagnosis and treatment so patients can be discharged.

Professor Krishna Sethia, medical director, said the current situation at the hospital was a reflection of pressure on the whole healthcare system and a spike in demand which had come earlier in the winter than normal.

He said: “Demand on the A&E department has gone up considerably. Five or six years ago we were seeing 60,000 patients a year and now we are seeing 100,000 patients a year.”

The hospital has also recently seen an increase in the last few months in the number of very ill patients, those who are often, but not always, elderly and have multiple health problems which are more complicated to treat and which means they stay in hospital for longer.

The hospital has been running an unplanned care clinic, manned by both hospital doctors and GPs, to help avoid unnecessary admissions and in the medium term it is planning to expand its A&E department.

Prof Sethia said: “The great thing is how everybody has worked together to keep it safe and I think it’s still safe.

“But that’s at the expense of people waiting longer with less urgent conditions than we would like them to do.”

• The Queen Elizabeth Hospital in King’s Lynn, above, still remains on “black alert”.

At the Gaywood Road site, it has been on the most severe internal status level since Friday, due to a shortage of beds and an extremely busy A&E department.

It is blamed on winter pressures such as illness especially affecting the elderly population.

Jane Tombleson, the hospital’s divisional director of emergency care, said that they were managing patient flow but said that they had “ambulances waiting outside”.

A spokesman for the hospital last night confirmed that the hospital was still on black alert but would not be making any further comment at this stage.

• Bosses at the James Paget Hospital have said their A&E is “very busy” as they continue to ask patients not to automatically attend the emergency department.

People suffering minor injuries and illnesses are urged to consider all options, such as asking a pharmacist for advice, visiting their GP or local walk-in centre or self care.

Sue Watkinson, director of operations, said: “We are very busy at the moment and have minimal beds available with some additional escalation beds open to meet our patients’ needs.”

“Please try and keep A&E for serious conditions and serious injuries. Consider using 111 for advice; it’s a lot easier sitting at home calling 111 than coming up to A&E unnecessarily. The vast majority of minor illnesses are self-limiting and do not need medical attention.”

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