Hospitals remain under intense pressure this winter from flu and illness caused by the cold weather, NHS England figures show.
A&E units had to divert patients to other hospitals 20 times last week, and more than 11,000 patients had to be looked after by ambulance crews for at least half an hour before they could be handed over to A&E nurses.
The figure of 20 A&E diverts in the seven days to last Sunday was a big rise on the six the week before. It means acute hospitals have now been forced to divert patients in ambulances to other nearby A&E units 208 times since winter began at the end of November.
Worcestershire Acute Hospitals NHS trust, which runs hospitals in Worcester and Redditch, has had the most A&E diverts (39) in that time, according to NHS England’s latest winter performance weekly data.
Gloucestershire Hospitals NHS foundation trust, which runs hospitals in Cheltenham and Gloucester, has had the second most (30).
Bed occupancy at general and acute hospital wards fell a little last week, from 94.9% to 94.8%, but it remains far higher than the 85% “safe” limit needed to reduce the spread of infections such as MRSA and the chance of patients receiving poor care.
Dr Nick Scriven, president of the Society for Acute Medicine (SAM), said the figures undermined Theresa May’s insistence at prime minister’s questions on Wednesday that the NHS in England was the best prepared for winter it has ever been.
“Pressures in the system remain high, and it really is offensive and disingenuous to see the prime minister only yesterday remain adamant that the NHS was better prepared than ever this winter,” he said.
A combination of factors are at play. Hospitals have fewer beds than last year, so they are less able to deal with the recent, ongoing surge in illness. Last week, for example, the bed occupancy rate at 17 of England’s 153 acute hospital trusts was 98% or more, with the fullest – Walsall healthcare trust – 99.9% occupied.
NHS England admits that the service “has been under sustained pressure [recently because of] high levels of respiratory illness, bed occupancy levels giving limited capacity to deal with demand surges, early indications of increasing flu prevalence and some reports suggesting a rise in the severity of illness among patients arriving at A&Es”.
Many NHS bosses and senior doctors say that the pressure the NHS is under now is the heaviest it has ever been. “We are seeing conditions that people have not experienced in their working lives,” says Dr Taj Hassan, the president of the Royal College of Emergency Medicine.
The unprecedented nature of the measures that NHS bosses have told hospitals to take – including cancelling tens of thousands of operations and outpatient appointments until at least the end of January – underlines the seriousness of the situation facing NHS services, including ambulance crews and GP surgeries.
The SAM represents doctors who look after many patients admitted to hospital, especially those who do not need surgery. “The overall mood among healthcare staff is that they remain anxious and depressed, and we simply cannot afford a repeat of these dire circumstances again,” Scriven added.
A recent SAM survey found that 75% of acute medicine doctors felt their hospitals were not properly prepared this winter, while 28% said they were in a worse position than last year. Those specialists believed that bed shortages, A&E units’ inability to cope with the number of patients arriving and shortages of both nurses and junior doctors were major problems, the survey found.
The new NHS England figures show that last week:
• 11,019 patients were stuck in the back of an ambulance, or in part of a hospital near the A&E, waiting to be handed over to staff for at least half an hour – fewer than the 12,559 who did so a week before.
• The average number of hospital beds closed each day last week owing to outbreaks of norovirus, the winter vomiting bug, rose to 859, up from 747 a week earlier.
While this year has brought the biggest flu outbreak since 2010-11, “instances of flu appear to be stabilising”, NHS England said. Public Health England will issue its weekly update on the impact of flu across the UK, including hospitalisations, deaths and GP visits, later on Thursday.
An NHS England spokesperson said: “While levels of flu have stabilised, there has been a spike in the number of norovirus cases, which continues to put pressure on busy hospitals and other frontline services. And while the NHS is generally coping with ongoing winter demands, the public can continue to play their part by using NHS 111 and pharmacists for advice.”
