Lancashire’s central hospitals have declared themselves winter ready – with the formation of a designated ‘winter ward’ and securing of almost £2 million of extra funding as part of efforts to avoid a repeat of last winter’s NHS crisis.
Lancashire Teaching Hospitals Trust, which operates Royal Preston and Chorley and South Ribble hospitals, has taken steps to deal with anticipated extra demand during the winter months.
At Chorley, the Trust has created a new ‘winter ward’ with 23 extra beds and an increase in senior doctors available to provide cover every day of the week, with the aim of minimising delays for patients.
Over at Royal Preston, the Trust has invested an extra £1.9 million of additional funding to improve facilities and capacity within the emergency department at the hospital.
During last winter’s NHS crisis, hundreds of patients waited for more than an hour in ambulances outside the hospitals.
Figures released by the health service showed 1,717 ambulances had A&E handover periods of more than 60 minutes between November 20, 2017, and March 4, 2018.
A further 2,154 waited between 30 and 60 minutes, longer than the recommended 15 minute target.
The bed occupancy rate also reached 95.9 per cent in the lead up to Christmas – above the 85 per cent threshold, after which the NHS states patient safety is compromised.
And last week the British Medical Association warned the NHS that it needs 10,000 additional hospital beds this winter in order to keep patients safe.
Karen Partington, chief executive of Lancashire Teaching Hospitals NHS Foundation Trust, said: “We’ve developed detailed plans and undertaken a wide range of actions already to make sure our patients receive safe and timely care this winter.
“The new dedicated ‘winter ward’ at Chorley is already open and fully operational to provide the extra bed capacity which we know we will need over the coming weeks.
“The building work we’ve undertaken within the emergency department at Preston to improve the facilities and increase the available space will also make a huge difference to reducing ambulance handover delays and improve our performance against the four-hour target too.
“Our new discharge process and dedicated discharge facilitators will also help to make sure that patients who are medically well enough to leave hospital do so as soon as possible.
“This will help to free up beds for the expected increase in the number of people needing to be admitted.
“The additional seven-day medical cover we have put in place will also mean that senior doctors are able to carry out daily reviews of patients and thus increase the number of safe weekend discharges.”
The extra funding of almost £2 million at Royal Preston is being used to provide extra cubicles to treat patients with serious conditions, a new space for frail elderly patients, a mobile x-ray unit, and IT improvement to better bed management in the hospital.
The Trust is also creating a new 24/7 Clinical Decisions Unit at Royal Preston with extra nurses for patients needing tests, scans or other care and treatment that currently extends their stay within the department.
A spokesman said: “This will free up doctors within the emergency department, and provide those patients with a better experience.”
The hospital’s Surgical Assessment Unit – used by patients undergoing emergency and elective surgery – has also been doubled in size, with the number of beds available increasing from eight to 16.
Teaming up with local care
Doctors across Preston, Chorley and South Ribble are working together to provide appointments on weekday evenings and weekends to make healthcare access easier for all – and in doing so, lessen the burden on A&E departments.
Denis Gizzi, chief officer of the clinical commissioning groups (CCGs) in Chorley, South Ribble and Greater Preston, said: “We are working closely with the hospital trust, and with other health and care partners in central Lancashire, to help manage demand and capacity over winter.
“As well as the initiatives at the hospital, we are making it easier to access services in the community to help keep people well.
“All GP practices across Chorley, South Ribble and Greater Preston are working together to offer their patients access to appointments on weekday evenings and at weekends to make it easier for people to see a GP or nurse.
“We are also asking our communities to help us help you this winter, by getting the free flu jab if you are eligible, and seeking advice early from a pharmacy or 111 before a minor illness worsens.”
‘We need 10,000 extra beds’
The news comes as The British Medical Association warned the NHS that it needs 10,000 additional hospital beds this winter in order to keep patients safe.
The BMA’s own analysis shows that “more than 300,000 patients could be left waiting on hospital trolleys in emergency care departments for more than four hours before being admitted”.
A spokesman added: “Last winter, bed occupancy in general and acute beds peaked at 95.1 per cent in February 2018, despite guidance from the National Audit Office suggesting occupancy should not exceed 85 per cent to avoid impacting on the quality of care.
“NHS Improvement has said that above 92 per cent, the deterioration in emergency care standards begins to accelerate.
“To bring bed occupancy down to the recommended minimum safe limit of 92 per cent, the NHS in England this winter will need to continue using 5,000 escalation beds opened at the peak of the winter crisis last year and will need an additional 5,000 general and acute beds.”
Dr Rob Harwood, BMA consultant committee chair, said: “The NHS is facing an all year crisis that is leaving patients in an intolerable situation. This winter could be the worst on record for frontline emergency care departments.
“Last winter saw incredibly high levels of bed occupancy, well above recommended limits, and despite thousands of escalation beds being put into action temporarily. At this level patients will struggle to get the attention and care they need.”