N&N bed problem getting worse
NEARLY 400 operations have been cancelled at Norfolk's biggest hospital this year in the most damning evidence yet of the county's bed shortages. A rise in bed-blocking, a surge in emergencies and the long-running lack of beds have combined to cause huge problems at the Norfolk and Norwich University Hospital.
NEARLY 400 operations have been cancelled at Norfolk's biggest hospital this year in the most damning evidence yet of the county's bed shortages.
A rise in bed-blocking, a surge in emergencies and the long-running lack of beds have combined to cause huge problems at the Norfolk and Norwich University Hospital. Patients are regularly being cared for in treatment rooms which are not designed for the purpose.
Bed-blocking has peaked at 82 beds in the 980-bed hospital, which has formed a double whammy with an unprecedented rise in emergency admissions - up 21pc, or 320 patients, in the four weeks to February 16 compared to the year before. The reasons for the rise are not fully understood but may include respiratory problems in a cold winter, and an ageing population. There has been a rise in emergencies across the country but as the busiest hospital in the region the N&N has suffered particularly badly.
At the Queen Elizabeth Hospital in King's Lynn, by comparison, the increase for February was 6pc on the same time the year before. Last week's figures show emergency admissions at the N&N were still up by 9pc during the previous 28 days, compared with the same time a year before.
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Cancellations were worst in January, when 256 operations were postponed. In February, there were 93, and up to March 12, 93 operations had been postponed. Those who have suffered this year include Russell Cullum, 77, from Spixworth, who was lying on a trolley in a hospital gown when his operation was postponed, Karen Bemrose, 47, from Long Stratton, who had her foot operation cancelled for the third time at the last minute, and breast cancer patient Jean Cottrell, 50, whose operation to remove her lymph glands where the cancer had spread had to be postponed.
Bed-blocking, or delayed discharges, is back up to the levels of last spring when local MPs held an inquiry because it was averaging around 60 beds. In January and February, 56-57 beds were blocked by people classed as fit to leave hospital, and on March 5 the figure soared to 82.
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Harry Seddon, Unison representative for the N&N, said: “The pressure is on everyone. Managers find themselves having to make really difficult decisions, like whether to cancel tomorrow's operations or continue, knowing it will add to pressure on staff. Individual staff find themselves under pressure to discharge patients sometimes ahead of plan. They find themselves having to decide which of their patients could least inappropriately be nursed in treatment rooms. No one wants to nurse in a treatment room.”
Norman Lamb, North Norfolk MP and Liberal Democrat health spokesman, said: “This is intolerable. Every cancelled operation is a story of someone in a state of anxiety, being prepared for their operation and then having to cope with the dismay of it not happening - sometimes at the last minute.
“When you have 50-60 people ready to leave who are still in hospital and you are cancelling operations, that demonstrates a failed system. To disrupt patients' lives in this way is totally unacceptable.”
A spokesman for the N&N said: “Over the last year, we have carried out a total of 73,619 elective admissions and only 689, or 0.94pc, were cancelled, with most of these occurring in January when we faced increased pressure following a large rise in emergency patients and high numbers of delayed discharges. We make great efforts to avoid cancelling surgery unless it is absolutely necessary and always prioritise patients who need urgent operations or have a high clinical need.
“Part of our plans for dealing with the increase in emergencies has been to use ward treatment rooms to create more capacity on the wards, enabling patients to be moved from the Emergency Assessment Unit at exceptionally busy times. We are not using treatment rooms today but have done so in the last week and patients are only moved to treatment rooms after careful assessment by the nursing staff as to their suitability.”
The hospital has taken a range of measures to ease the pressures, including medicines being got ready the night before patients are due to go home, earlier review of patients by senior doctors, increased access to diagnostic scanning, and short-notice outpatient emergency clinics to reduce emergency admissions. A new discharge lounge has been opened in a room that was the doctors' mess, to give patients somewhere to sit while they are waiting to go home instead of taking up a bed. The hospital is also working with NHS Norfolk and social services to reduce bed-blocking.