Patients may be at risk from a shortage of beds, staff and money that threatens to undermine the most extensive preparation ever undertaken by the NHS, hospital trusts have warned.
With the health service entering its busiest three months of the year, the body that represents hospital, ambulance and mental health trusts says its members will be “sorely tested” this winter despite months of planning.
NHS Providers say hospitals are already severely stretched, with bed occupancy in some trusts running at 98%, and significant delays in transferring patients out of hospital reducing the capacity for new admissions.
Among the measures the NHS and local hospitals have taken to try and ensure safe, high-quality care are:
:: Contingency plans to support trusts facing the greatest pressure
:: Extending the number of GPs “streaming” patients in A&E to reduce strain on emergency departments
:: Local “resilience plans” involving co-operation between health and social care organisations
:: Work to improve the “flow” of patients through hospitals
Early figures appear to suggest the measures may be working, with the latest figures from Public Health England showing there were no flu-related deaths reported in the week ending 26 November (week 47). Last year, there were 133 deaths over the 26 weeks of the winter – an average of around five a week.
In addition, there were 11 A&E diverts in week 47, compared to 39 in week 46, 10,200 ambulance delays of over 30 minutes, down from 10,600 the week before and the number of bed closures due to Norovirus or Diarrhoea and Vomiting fell slightly from an average of 680 beds to 664 beds closed per day.
Meanwhile, hospital trusts reported bed occupancy levels of 94.5% – up slightly from 94.3% the previous week and there were 274,600 calls offered to the NHS 111 service in the week ending Sunday 3 December, more than the previous week, which had 269,300.
While trusts are hopeful the plans they have put in place will help mitigate some of the issues the health service will face this winter, they say major challenges remain.
Many hospitals privately admit that they have been unable to meet targets to free up bed capacity by discharging more patients ahead of the winter peak, a plan that was supposed to provide an additional 3,700 beds across England.
This increases the prospect of a repeat of last year’s difficult winter, when some A&E departments were forced to turn patients away.
The Government provided an additional £350m in the Budget to help the NHS cope with winter, but many believe the money was committed too late to be effectively spent.
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He said: “Winter has definitely arrived, we’ve noticed that. We had 530 attendances here in Newham on Monday, our normal rate is about 430, so you can see that the numbers are going up.
“But we saw 97% of people within four hours yesterday which is a terrific performance by this hospital, so we are coping.
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“We’ve now got a system wide plan which involves not just the hospitals in the area but also social services, community services, metal health and primary care. So we’ve got one big system working together for patients.”
The chief executive of NHS Providers, Chris Hopson, said: “Our report highlights the range of measures trusts have put in place to improve resilience and provide safe, timely care for patients.
“But we have to recognise we are not where we would want to be as we head into winter.