This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.
You can find the current article at its original source at http://www.theguardian.com/society/2015/jan/06/hospitals-struggling-demand-cancel-operations-major-incidents
The article has changed 8 times. There is an RSS feed of changes available.
| Version 4 | Version 5 |
|---|---|
| Eight more hospitals declare critical incidents as demand surges | Eight more hospitals declare critical incidents as demand surges |
| (about 1 hour later) | |
| Eight more hospitals have declared major or significant incidents, amid mounting evidence that A&E departments are struggling to cope with unprecedented demand on their services. | Eight more hospitals have declared major or significant incidents, amid mounting evidence that A&E departments are struggling to cope with unprecedented demand on their services. |
| Hospital A&E units recorded their worst ever performance in the week before Christmas as NHS emergency care services struggled to deal with an unprecedented number of patients, figures released on Tuesday showed. The figures vary widely between hospitals, with some now on the verge of a crisis. | Hospital A&E units recorded their worst ever performance in the week before Christmas as NHS emergency care services struggled to deal with an unprecedented number of patients, figures released on Tuesday showed. The figures vary widely between hospitals, with some now on the verge of a crisis. |
| The Guardian has established that there are seven more hospitals declaring a major or significant incident, meaning they are struggling so much with demand that they are being forced to cancel planned operations or asking people to come to A&E only in an extreme emergency. They take the current number of hospitals with that status to at least 15. | The Guardian has established that there are seven more hospitals declaring a major or significant incident, meaning they are struggling so much with demand that they are being forced to cancel planned operations or asking people to come to A&E only in an extreme emergency. They take the current number of hospitals with that status to at least 15. |
| But David Cameron denied the problems placed the NHS “on the brink of disaster”. | But David Cameron denied the problems placed the NHS “on the brink of disaster”. |
| “We’ve got a short-term pressure issue which we need to meet with resources and management,” he told BBC London 94.9’s Eddie Nestor. | “We’ve got a short-term pressure issue which we need to meet with resources and management,” he told BBC London 94.9’s Eddie Nestor. |
| “We’ve got a longer-term issue which is making sure that there are named GPs in your local area which are responsible for every single frail, elderly person. | “We’ve got a longer-term issue which is making sure that there are named GPs in your local area which are responsible for every single frail, elderly person. |
| “A lot of the pressure on A&E is coming from frail, elderly people, often with many different health conditions and the best place for them, frankly, is not A&E. | “A lot of the pressure on A&E is coming from frail, elderly people, often with many different health conditions and the best place for them, frankly, is not A&E. |
| “They should be being looked after by the family doctor or in other health settings and I think the long term challenge is to make sure those sorts of settings are more available.” | “They should be being looked after by the family doctor or in other health settings and I think the long term challenge is to make sure those sorts of settings are more available.” |
| Peterborough city hospital cancelled eight operations on Tuesday, after cancelling nine on Monday, in order to prioritise emergency care. | Peterborough city hospital cancelled eight operations on Tuesday, after cancelling nine on Monday, in order to prioritise emergency care. |
| At 1pm on Tuesday there were 53 people in A&E seeking treatment at the Royal Bolton hospital, 15 of whom were waiting for a bed on a ward. It said some patients had had to wait almost 12 hours for a bed after it had been decided to admit them. | At 1pm on Tuesday there were 53 people in A&E seeking treatment at the Royal Bolton hospital, 15 of whom were waiting for a bed on a ward. It said some patients had had to wait almost 12 hours for a bed after it had been decided to admit them. |
| The trust’s chief operating officer, Andy Ennis, said the main issue was “quickly freeing up beds and finding places for those patients who no longer need hospital care”. | The trust’s chief operating officer, Andy Ennis, said the main issue was “quickly freeing up beds and finding places for those patients who no longer need hospital care”. |
| Wallsall Manor hospital is trying to open a new 30-bed ward early next week to help take the strain. It said has cancelled some planned surgery, scaled back staff training and ensuring outpatient clinics were not taking staff away from the emergency frontline. The trust chief executive, Richard Kirkby, said: “We have put arrangements in place so that we are able to focus on the priority of ensuring we can care safely for the patients already in the hospital.” | Wallsall Manor hospital is trying to open a new 30-bed ward early next week to help take the strain. It said has cancelled some planned surgery, scaled back staff training and ensuring outpatient clinics were not taking staff away from the emergency frontline. The trust chief executive, Richard Kirkby, said: “We have put arrangements in place so that we are able to focus on the priority of ensuring we can care safely for the patients already in the hospital.” |
| GPs in Bedford received a message through an online system for doctors on Tuesday afternoon saying Bedford hospital had declared a significant incident. The message title was: “A significant deterioration in the resilience of the Bradford hospital emergency care system.” | GPs in Bedford received a message through an online system for doctors on Tuesday afternoon saying Bedford hospital had declared a significant incident. The message title was: “A significant deterioration in the resilience of the Bradford hospital emergency care system.” |
| Brighton and Sussex University hospitals trust, which termed its incident “significant”, said the Princess Royal Brighton and the Royal Sussex had cancelled some appointments, clinics and operations but did not provide further details. Norwich and Norfolk hospital revealed it had reinstated an “internal major incident” and was discharging patients able to go home immediately to increase capacity to meet demand.Stoke Mandeville hospital, in Buckinghamshire, has opened up additional areas and increased clinical staff on wards. | Brighton and Sussex University hospitals trust, which termed its incident “significant”, said the Princess Royal Brighton and the Royal Sussex had cancelled some appointments, clinics and operations but did not provide further details. Norwich and Norfolk hospital revealed it had reinstated an “internal major incident” and was discharging patients able to go home immediately to increase capacity to meet demand.Stoke Mandeville hospital, in Buckinghamshire, has opened up additional areas and increased clinical staff on wards. |
| The others known to be affected are the Royal Stoke University hospital, Stafford hospital, Gloucestershire Royal hospital, Cheltenham General hospital, Scarborough hospital, Ashford and St Peter’s hospitals. At 10.30am on Tuesday, there were 19 patients waiting to see a doctor at the Gloucestershire Royal, with the longest wait 128 minutes, and 10 waiting to see doctor at Cheltenham General, where the longest wait 54 minutes. Staff say the waiting times were higher than normal and expected to increase. | The others known to be affected are the Royal Stoke University hospital, Stafford hospital, Gloucestershire Royal hospital, Cheltenham General hospital, Scarborough hospital, Ashford and St Peter’s hospitals. At 10.30am on Tuesday, there were 19 patients waiting to see a doctor at the Gloucestershire Royal, with the longest wait 128 minutes, and 10 waiting to see doctor at Cheltenham General, where the longest wait 54 minutes. Staff say the waiting times were higher than normal and expected to increase. |
| The pressures facing A&E departments were highlighted by a tweet sent out by Nottingham University hospitals on Sunday urging off duty nurses and doctors who were able to work extra hours to get in touch. | The pressures facing A&E departments were highlighted by a tweet sent out by Nottingham University hospitals on Sunday urging off duty nurses and doctors who were able to work extra hours to get in touch. |
| Different trusts appear to define what constitutes a major incident differently, with one telling the Guardian that it would only use such terms for an external event, such as a major accident or attack that caused a number of injuries and/or fatalities. | Different trusts appear to define what constitutes a major incident differently, with one telling the Guardian that it would only use such terms for an external event, such as a major accident or attack that caused a number of injuries and/or fatalities. |
| The NHS defines a major incident as “any occurrence that presents serious threat to the health of the community, disruption to the service or causes (or is likely to cause) such numbers or types of casualties as to require special arrangements to be implemented by hospitals, ambulance trusts or other acute or community provider organisations”. | The NHS defines a major incident as “any occurrence that presents serious threat to the health of the community, disruption to the service or causes (or is likely to cause) such numbers or types of casualties as to require special arrangements to be implemented by hospitals, ambulance trusts or other acute or community provider organisations”. |
| The Queen Elizabeth hospital in King’s Lynn has been on “black alert”, the step below a major incident, since the weekend. | The Queen Elizabeth hospital in King’s Lynn has been on “black alert”, the step below a major incident, since the weekend. |
| A 16th hospital, Croydon University, briefly declared “an internal major incident” on Tuesday morning but downgraded it in the afternoon. | A 16th hospital, Croydon University, briefly declared “an internal major incident” on Tuesday morning but downgraded it in the afternoon. |
| Other hospitals appeared to be taking similar action to those that had declared major incidents, while avoiding using the actual term. | Other hospitals appeared to be taking similar action to those that had declared major incidents, while avoiding using the actual term. |
| Epsom and St Helier University Hospitals NHS trust declared a “business continuity incident” on Tuesday and said consultants were asked to review patients’ conditions to see if they could be discharged to free up beds. | Epsom and St Helier University Hospitals NHS trust declared a “business continuity incident” on Tuesday and said consultants were asked to review patients’ conditions to see if they could be discharged to free up beds. |
| The Isle of Wight NHS trust cancelled some planned operations on Tuesday and said ambulances were queuing because of a lack of beds, but it did not formally declare a major incident. One of Britain’s best known hospitals, | |
| Hereford hospital said it has cancelled routine operations, while non-essential surgery had been cancelled this week at the Great Western Hospitals NHS Foundation Trust, which has had two significant incidents since 1 December 2014. | Hereford hospital said it has cancelled routine operations, while non-essential surgery had been cancelled this week at the Great Western Hospitals NHS Foundation Trust, which has had two significant incidents since 1 December 2014. |
| The Royal Bournemouth hospital said it had 35 patients who were medically fit to go home but were still occupying beds because of problems with transfer of care. Hospitals in Scotland and Wales are experiencing similar pressures. NHS Greater Glasgow and Clyde has postponed 44 procedures, while NHS Grampian cancelled 20 minor operations on Tuesday, while Welsh health boards reported that they have implemented special measures due to high capacity. | The Royal Bournemouth hospital said it had 35 patients who were medically fit to go home but were still occupying beds because of problems with transfer of care. Hospitals in Scotland and Wales are experiencing similar pressures. NHS Greater Glasgow and Clyde has postponed 44 procedures, while NHS Grampian cancelled 20 minor operations on Tuesday, while Welsh health boards reported that they have implemented special measures due to high capacity. |
| The Abertawe Bro Morgannwg University Health Board, which runs several hospitals around Swansea, Neath Port Talbot and Bridgend, estimated that around 20 to 25 non-essential operations were being postponed per day, while Wales’ largest health board, Betsi Cadwaladr University Health Board, also reported that it had reduced its routine operations and brought in more staff and extra beds. | The Abertawe Bro Morgannwg University Health Board, which runs several hospitals around Swansea, Neath Port Talbot and Bridgend, estimated that around 20 to 25 non-essential operations were being postponed per day, while Wales’ largest health board, Betsi Cadwaladr University Health Board, also reported that it had reduced its routine operations and brought in more staff and extra beds. |
| The A&E waiting times data triggered a furious political argument over the causes of the problems. “Type 1” A&Es, emergency departments based at hospitals in England, treated and either admitted or discharged just 83.1% of arrivals within the politically important four-hour target in the week ending Sunday 21 December. | The A&E waiting times data triggered a furious political argument over the causes of the problems. “Type 1” A&Es, emergency departments based at hospitals in England, treated and either admitted or discharged just 83.1% of arrivals within the politically important four-hour target in the week ending Sunday 21 December. |
| The NHS also recorded its worst A&E performance using the preferred measure of NHS England and the Department of Health, which includes patients receiving urgent and emergency care in settings such as walk-in and urgent care centres, which are based at GP surgeries, on high streets or at some hospitals. | The NHS also recorded its worst A&E performance using the preferred measure of NHS England and the Department of Health, which includes patients receiving urgent and emergency care in settings such as walk-in and urgent care centres, which are based at GP surgeries, on high streets or at some hospitals. |
| In the week before Christmas, just 88.8% of those arriving at all those places were dealt with within four hours, though that rose to 90.5% the following week. The 88.8% performance is the worst yet against the four-hour target, and was a drop on the 89.6% seen a week before, which was itself a record low. | In the week before Christmas, just 88.8% of those arriving at all those places were dealt with within four hours, though that rose to 90.5% the following week. The 88.8% performance is the worst yet against the four-hour target, and was a drop on the 89.6% seen a week before, which was itself a record low. |
| The NHS constitution states that 95% of all A&E patients should be dealt with within four hours. | The NHS constitution states that 95% of all A&E patients should be dealt with within four hours. |
| Speaking before the publication of the figures, the health secretary, Jeremy Hunt, acknowledged the NHS was under immense pressure, but insisted the four-hour target was being met in 90% of cases. | Speaking before the publication of the figures, the health secretary, Jeremy Hunt, acknowledged the NHS was under immense pressure, but insisted the four-hour target was being met in 90% of cases. |
| But Andy Burnham, the shadow health secretary, said the government should take emergency steps to help the NHS cope. | But Andy Burnham, the shadow health secretary, said the government should take emergency steps to help the NHS cope. |
| “The secretary of state hasn’t put plans in place to ensure the NHS can get safely through the winter. He must urgently do so.” | “The secretary of state hasn’t put plans in place to ensure the NHS can get safely through the winter. He must urgently do so.” |
| The British Medical Association, which represents doctors, demanded urgent improvements to the overall system of NHS care to relieve the pressure on hospitals, such as improving the NHS 111 telephone advice service and providing better social care services to help vulnerable patients stay well at home. | The British Medical Association, which represents doctors, demanded urgent improvements to the overall system of NHS care to relieve the pressure on hospitals, such as improving the NHS 111 telephone advice service and providing better social care services to help vulnerable patients stay well at home. |
| “Staff are working flat out but the system is struggling to cope with the sheer number of patients coming through the door,” said Dr Mark Porter, the BMA’s leader. | “Staff are working flat out but the system is struggling to cope with the sheer number of patients coming through the door,” said Dr Mark Porter, the BMA’s leader. |
| “Doctors must be able to treat the patient who’s in front of them based on their individual needs, which is why doctors don’t agree with targets for targets’ sake. Moving away from a system which prioritises targets above all else can help to improve the quality of care doctors are able to give patients by preventing rushed admissions or leaving those most in need waiting longer for treatment. But this will only work in the best interests of patients, if the NHS has the staff and resources it needs to meet rising patient demand,” he said. | “Doctors must be able to treat the patient who’s in front of them based on their individual needs, which is why doctors don’t agree with targets for targets’ sake. Moving away from a system which prioritises targets above all else can help to improve the quality of care doctors are able to give patients by preventing rushed admissions or leaving those most in need waiting longer for treatment. But this will only work in the best interests of patients, if the NHS has the staff and resources it needs to meet rising patient demand,” he said. |
| The Royal College of Nursing said the A&E figures were evidence that the overall health and social care system was in crisis and demanded proper funding to fix the growing problems. | The Royal College of Nursing said the A&E figures were evidence that the overall health and social care system was in crisis and demanded proper funding to fix the growing problems. |
| “Hospital trusts trying to recruit more staff have been hamstrung by the short-sighted cuts to nurse training places, which means there simply aren’t enough nurses in the system,” said Dr Peter Carter, the union’s chief executive and general secretary. “This is made worse by chronic under-resourcing of community services and social care, which means more people end up in A&E who could be better treated elsewhere … | “Hospital trusts trying to recruit more staff have been hamstrung by the short-sighted cuts to nurse training places, which means there simply aren’t enough nurses in the system,” said Dr Peter Carter, the union’s chief executive and general secretary. “This is made worse by chronic under-resourcing of community services and social care, which means more people end up in A&E who could be better treated elsewhere … |
| “Nothing short of a long-term strategy and a significant long-term investment in our health service will put an end to this crisis.” | “Nothing short of a long-term strategy and a significant long-term investment in our health service will put an end to this crisis.” |