Hospitals in race to combat ‘toughest ever’ winter crisis for NHS
Hospitals are bringing in GPs, reopening mothballed wards and offering daycare for their staff’s children in a desperate attempt to avoid being overwhelmed this winter.
NHS trusts are expanding A&Es, paying for patients to be cared for in nursing homes and looking after more people at home to help them cope with the impending winter crisis, which experts have warned will be the toughest ever. Patients also face being moved between hospitals to help relieve overcrowding as the
NHS braces for a surge in demand during December, January and February.
The unprecedented array of emergency measures are a response to signs that in some places the number of people turning up at A&E is as much as 30% higher than a year ago.
Each day Southend hospital in Essex is sending 50 patients with minor ailments to see a GP or practice nurse instead of A&E staff. The Wrightington, Wigan and Leigh trust in Lancashire (WWL) plans to open its GP-run walk-in centre at Wigan Infirmary, all day, every day in January. Currently it is open from 9am to 9pm.
Andrew Foster, WWL’s chief executive, said: “The good news is that we don’t have
the flu we had last winter and have put a lot of things in place for this winter. The bad news is that 4% more people than last year are arriving at A&E, the number we’re admitting is 12% up on last year and the people coming in are sicker.”
Nottingham’s main hospital trust has added 10 cubicles to A&E and has refurbished a unit to provide 48 beds across two new temporary wards.
In the north-east, nine hospitals will divert non-urgent patients to each other, depending on how busy they are, using an app developed with the regional NHS ambulance service. In the north-west, ambulance crews and hospital trusts are collaborating to cut the number of people they take to hospital after a 999 call by 40% by treating more at the scene, getting a nurse to come to them or arranging social care instead.
Maidstone and Tunbridge Wells trust in Kent has launched a “hospital at home” service in tandem with the county’s community healthcare trust under which patients who can be safely looked after at home are visited by nurses and therapists rather than taking up a hospital bed.
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Pressure on beds has prompted the trust that runs Ipswich and Colchester hospitals to hire 70 nursing home beds for patients who do not need to be admitted or are undergoing rehabilitation. However, the homes’ owners hit the trust with a last-minute price rise, from £750 to £1,000 per bed a week. Sherwood Forest trust in Nottinghamshire also bought 20 care home places, which are already full.
Professor Keith Willett, NHS England’s medical director for acute care, praised trusts for putting in place “innovative and practical measures”.
“Following an unprecedented summer surge, the NHS is going into this winter under pressure but with hospitals preparing very carefully, learning from what worked from last winter ,The wider NHS has also developed measures to ease pressure, helped by even more doctors, nurses and pharmacists working in NHS 111 and greater access to evening and weekend GP appointments,” he added.
Trusts also plan to help staff cope with any disruption from a repeat of last winter’s prolonged snow. Northampton has struck a deal with a specialist 4x4 transport service to collect snowbound nurses and doctors and get them to work. It is also reviving its “snow school” activity group for children for days when schools are shut due to bad weather so their parents do not have to miss shifts. “We expect this winter to be tougher than last,” said Sonia Swart, the trust’s chief executive. By Friday, the number of people who had attended its A&E was already at 99,001 – about 30% higher than the same time last year.
But Nick Scriven, president of the Society for Acute Medicine, which represents some hospital doctors, doubted the measures would stop the NHS going into meltdown. “I’m afraid the NHS plan for winter this year could be summed up yet again as too little too late,” he said.
Chris Hopson, the chief executive of NHS Providers, which represents trusts, said: “Trusts have once again gone to great lengths to prepare ahead of what is likely to be an extremely challenging winter.”
“Despite these efforts, no one should be in any doubt that the next few months will be extremely tough. We have slipped back in terms of performance against the main NHS targets compared to this time last year, finances are stretched, social care and GPs are under greater pressure and workforce shortages have got worse.
“Trusts tell us that this winter is therefore likely to be more difficult than the last, despite all the preparation work they have been doing,” Hopson added.
