A&E bosses warn of 'intolerable' safety risks as visitors describe "heartbreaking" staff pressures at N&N
PUBLISHED: 17:50 11 January 2018 | UPDATED: 08:23 12 January 2018
Archant Norfolk 2017
The heads of the three A&E departments in our region have written to the Prime Minister warning safety levels are "intolerable" amid "severe and chronic underfunding" of the NHS.
According to figures released by NHS England more than 700 patients waited more than four hours at the Norfolk and Norwich University Hospital (NNUH) emergency department during December.
The figures showed A&E waiting times across the country had hit its lowest point in 14 years, with an average of 81pc of patients seen within the four hour marker in the last month of 2017.
As winter pressures built at NNUH only 69pc of admissions into A&E were seen within four hours in December, the figures showed. The hospital claimed the figures are “incomplete” and that 81pc of patients were seen within four hours across all relevant emergency areas.
Problems also persist at the James Paget University Hospital, where beds were full every day from before New Year’s Eve to January 7.
Non-urgent operations at the hospital were cancelled last week; a decision chief executive Christine Allen said “had not been taken lightly”.
“This sustained pressure is affecting hospitals both regionally and nationally, which have seen a substantial increase in pressure following the Christmas and New Year break,” she said.
A letter to Theresa May, signed by 60 A&E department heads, including Jim Crawfurd from JPUH, Tarek Kherbeck from NNUH, and Nam Tong from the Queen Elizabeth Hospital (QEH) in King’s Lynn, warned of their “very serious concerns” for patient safety.
“We feel compelled to speak out in support of our hardworking and dedicated nursing, medical and allied health professional colleagues and for the very serious concerns we have for the safety of our patients,” they wrote.
“This current level of safety compromise is at times intolerable, despite the best efforts of staff.”
The latest figures released by NHS Digital show bed occupancy rates have been at 100pc at JPUH from December 27 to January 7.
Ambulance handover times have improved at NNUH since a number of delays on Christmas Eve and Christmas Day, with no delays of more than 30 minutes since Boxing Day.
More than 5,000 people were forced to wait more than an hour to be seen in emergency departments in England in the first week of the year, while more than 16,600 people had to wait more than half an hour, the NHS England statistics show.
Staff have been faced with rising numbers of flu cases and respiratory illness, with 48 flu-related deaths in England so far this winter.
The letter, leaked to the Health Service Journal, signed by consultants in charge of emergency departments in 68 acute hospitals across England and Wales, acknowledged the best efforts of staff, trusts and clinical commissioning groups.
But it adds: “The facts remain, however, that the NHS is severely and chronically underfunded.”
“Thousands of patients are waiting in ambulances for hours as the hospitals lack adequate space,” they wrote.
“Some of our own personal experiences range from over 120 patients a day managed in corridors, some dying prematurely.
“An average of 10-12 hours from decision to admit a patient until they are transferred to a bed.”
Answering questions after a speech in south London on Thursday, Mrs May said flu was putting extra pressure on services.
“As we know, every year and winter the National Health Service comes under additional pressure, and we’ve seen the extra pressures that the NHS has come under this year,” she said.
“We have seen in recent days an increase in the number of people presenting at Accident and Emergency from flu.
“The NHS today has launched their national flu programme and I would encourage people to act on the advice that the NHS is giving and also encourage NHS staff who haven’t had the flu vaccine yet to have that vaccine.”
Responding to new A&E figures Dr Chaand Nagpaul, British Medical Association council chair, said: “Doctors will be horrified but not surprised by these figures. Behind each statistic is a patient waiting longer for care, often in distress, and doctors working under impossible conditions, exhausted and frustrated that they can’t provide the compassionate and quality care they want to for their patients.
“Hospitals exist to treat the ill, to make people better, and yet doctors are reporting that patients are dying in hospital corridors and hospital leaders are warning of a watershed moment for the NHS. These echo concerns we’ve had from our members across the country and the government must now take action.”
The “troubling and heartbreaking” pressures placed on A&E staff at the Norfolk and Norwich University Hospital have today been outlined by one of its visitors.
Jon Rogers attended the emergency department on Wednesday night and later tweeted his experiences on the front line.
“When I limped to X-ray, I counted four people on beds in a corridor,” he said. “FOUR. Including a middle aged couple holding the hand of a very frail and elderly lady in the bed. In a corridor. A cold, undignified, open corridor.
“A lady joined the queue to see reception to asked why her 90-year-old mother was currently still in an ambulance and have been sitting there for over two hours.
“No beds available for her.
“Not a single member of staff smiled during my visit, and when I left I realised that this wasn’t through lack of manners or attitude, but through utter exhaustion, lack of resources and facing a black wall every single day.
“12 hours of heart breaking shifts making decisions with little pay, little resources and little respect - can do that to you.
“So thank you to the staff. I, and millions of others, are with you.”
Chief executive at JPUH Christine Allen has said previously of the struggles faced by the hospital this winter: “The latest figures simply reflect the exceptional pressure that our hospital has faced since the New Year period.
“In particular, it was an extremely challenging and demanding New Year weekend, with huge pressure in our A&E department and on our bed capacity.
“The efforts of our staff have been immense and they have shown exceptional teamwork and dedication in caring for our patients.”
NNUH Chief Operating Officer Richard Parker said: “Recently published figures on our A&E performance against the four-hour target are unfortunately incomplete. Our performance, inclusive of all relevant emergency areas, is 81pc, one of the best performing Trusts in the country.”
“The hospital is extremely busy as would be expected during this winter period, and Trusts across the country are facing similar pressures. The Trust has made preparations for these pressures, improving efficiencies throughout the year and our staff are working hard to ensure excellent patient care is maintained at all times.”
With 34 escalation beds remaining open at the QEH and more than 5,000 people attending its A&E last month, chief executive Jon Green said “the pressure has not eased off”.
“We are continuing to see large numbers of seriously unwell patients arriving at the hospital along with significant levels of staff sickness,” he said.
“While the pressure has not eased off since New Year’s Eve, it is a testament to the hard work and dedication of our frontline staff that we have seen a reduction in ambulance handover delays.
“Our priority is patient safety and our staff have worked exceptionally hard to maintain this at all times and I would like to take this opportunity to thank them for everything they have done for our patients.
“While we would not wish to deter anyone from seeking medical treatment, we would ask people to consider alternative options to A&E such as your local pharmacist or calling 111 or downloading our Choose Well App.”
Patients are being urged not to use A&E unless it is a genuine emergency. For minor conditions, GPs, pharmacies and the NHS 111 service will be able to assist or to signpost to the most appropriate service.