A senior figure in Staffordshire's NHS has asked whether a 'half-baked' plan to close community hospital beds has contributed to A&E chaos this winter.

In the week before Christmas emergency patients at Royal Stoke were left waiting in ambulances for nearly three hours on average, with 22 patients waiting over 12 hours, due to A&E being overwhelmed.

University Hospitals of North Midlands, which runs the Royal Stoke, declared its latest critical incident on New Year's Day, following this 'sustained increase in pressures'.

At their meeting on Wednesday, UHNM board members were told the Royal Stoke was having to contend with both ambulance arrivals and bed occupancy rates being much higher than expected. The hospital's medical beds were above 100 per cent capacity for three consecutive days between December 27 and 29.

Trust chairman David Wakefield asked senior managers to look into whether the current problems were linked to the controversial decision by NHS commissioners to permanently close more than 100 community hospital beds in Leek, Longton, Cheadle and Bradwell in 2020. At the time, the area's clinical commissioning groups said the overhaul would allow care to be delivered closer to where people live, reduce hospital admissions and make health services more sustainable.

University Hospitals of North Midlands declared its latest incident on New Year's Day (SWNS).

Mr Wakefield said: "After winter we will have a board review on how winter has gone. The paper says that admissions are really no different to last year. The real issue is the number of ambulances turning up. One question is, why are the ambulances turning up? And the other question is why can't we deal with that – why can't we get people out of the hospital?

"When I joined this trust we'd just announced that we were closing all the local cottage hospitals. I can remember having conversations with the CCG at the time, and asking whether this was sensible. I was told that patients would be dealt with in the community. So I'd like to understand formally – are we now suffering the failure of a strategy that was half-baked, or a lack of investment to make it successful?"

Helen Ashley, director of strategy and performance, said that 'on the surface' it would be 'difficult to argue' that the closure of the community hospital beds had not had an impact. She told the board that a formal review into the issue was being planned.

She said: "When those beds were closed the intention was always to supplement any beds with care home capacity. We need to understand as a whole system whether or not that has played out. When we talk about spot purchase of care home capacity, is that what we always intended to do or are we doing that in extremis?"

Mr Wakefield added: "I do fear for patients sitting on ambulances for hours on end. I've been down to A&E during period when it's been absolutely hammered. And it's hammered this week again. The staff are up to their necks in it. So it's not good for anybody."

Between December 21 and December 29, more than 120 ambulances arrived at Royal Stoke each day (SWNS).

Chief operating officer Katy Thorpe gave the board an update on the ambulance handover delays and winter pressures facing UHNM, saying that both bed occupancy and ambulance arrivals had been 'outside of normal variation'.

Between December 21 and December 29, more than 120 ambulances arrived at Royal Stoke each day, peaking at 160 arrivals on Boxing Day. In the week ending December 21, the average ambulance handover took two hours 51 minutes – although this average fell considerably to one hour two minutes the following week.

A number of actions are being taken to mitigate the situation, including 'flipping' orthopedic beds to medical and opening additional community hospital beds, with 'harm reviews' for all patients waiting in ambulances for more than seven hours.

Ms Thorpe added that increased use of 'call before convey', where ambulance crews call for guidance before bringing non-urgent patients to hospital, could help reduce admissions. At the moment the system is used in just 2.1 per cent of cases, compared to a regional average of six per cent.

Chief executive Simon Constable said there was no single 'silver bullet' which would solve the problem.

He said: "It's not just the number – it's how sick people are. With all the other strategies to keep all but the sickest patients away from hospital, what tends to occur is that even if your numbers aren't up, the patient tend to be the sickest ones. We are dealing with a sicker cohort of patients, which does take more time, both in terms of an initial assessment and also what subsequently goes on.

"Clearly the situation isn't good enough and we all acknowledge that. We have been an outlier for this particular pathway for some time."

------------

READ MORE: What's on in Stoke this weekend: Winter trail, afternoon tea and workshop open day

Free from clickbait, pop-up ads and unwanted surveys, Stoke Nub News is a quality online newspaper for our city.

Subscribe to our FREE weekly newsletter email HERE - just click the 'SIGN UP' button.

Please consider following Stoke Nub News on Facebook or Twitter.