Patient safety

Lack of beds to put strain on NHS despite trusts’ preparation efforts for winter

Trusts have done all they can to prepare for winter, but a lack of beds and shortages in key staff areas means organisations will still be at “close to full stretch”, NHS Providers has warned.

In its new report, ‘Ready and resilient? How NHS trusts have prepared for winter’, the organisation outlines what trusts have done to ensure safe, high quality care for patients.

The organisation has said that whilst planning for winter is “more meticulous than ever before,” the health service is “already at or close to full stretch”, and so may be tested over the coming months.

Trusts have taken steps such as implementing local resilience plans with partner organisations, like social care services, by introducing checklists to standardise the delivery of basic care.

Nationally, there have been steps which NHS Providers has said will improve NHS resilience, including the appointment of Pauline Philip as national director responsible for winter planning, and putting in place contingency plans to support those trusts at greatest risk of struggling over the winter.

It says that the additional £335m in the 2017 budget will help the NHS to cope with the winter.

Although Providers says that trusts are as prepared as they can be, the report highlights the difficulties that may reduce trusts’ abilities to cope, including staff shortages and funding pressures.

This year’s flu strain is  “potentially the worst" in two decades, having already placed Australian and New Zealand health systems under “severe pressure” earlier this year.

The NHS’s bed shortage will also place the system under strain, with bed occupancy running at 87% on average and and being worsened by a sharp rise in delayed discharges.

Chris Hopson, chief executive of NHS Providers, explained that winter is always a challenge to the NHS.

“Last year the pressures were intolerable. Services were stretched up to, and in some places beyond, breaking point,” he said.

“This time preparations have never been more thorough.”

Hopson added that the report demonstrates the range of measures trusts have put into place to improve resilience and the work that national bodies are doing to support this.

He continued: “But we have to recognise we are not where we would want to be as we head into winter.

“The NHS is already under severe pressure, and while the additional funding in the recent Budget is welcome, it has come very late to be used to maximum effect.

“We cannot say with certainty how tough this winter will be, but the likelihood is that services will be sorely tested.”

President of the Royal College of Physicians, Professor Jane Dacre, wrote to NHS trust chief executives early last month with guidance on how to mitigate winter pressures, and said that it is “reassuring” that measures have been put in place in preparation for the winter.

Dacre said: “The measures largely echo our advice, and in addition to the measures directly aimed at patients, hospitals must put facilities and plans in place to protect the physical and mental wellbeing of the workforce.

“We hope that the recent funding increase from the chancellor will be made quickly and easily available to the NHS and agree with NHS Providers that using some of it to buy more social care and extra staff will ease the burden on our hospitals.”

Glen Burley, chief executive of South Warwickshire NHS Foundation Trust, described some of the measures put in place for winter, including the pending opening of the redesigned emergency assessment unit.

He said: “In Wye Valley we’ve been looking at staffing out of hours and at night time particularly to ensure that we’ve got the right staffing to meet demand, and at both trusts we’ve been really focussed on staff flu vaccination.”

West Midlands Ambulance Service NHS Foundation Trust’s chief executive, Anthony Marsh, said that the trust has been putting extra nurses, GPs and paramedics in its call centers, which has reduced the number of patients taken to hospital, whilst supporting the handover of patients that do require hospital attendance.

Karen Partington, chief executive of Lancashire Teaching Hospitals NHS Foundation Trust, described the creation of a “ward liaison officer role.”

“It takes away some of the administrative roles, chasing up scans, making sure we’ve got the pharmacy in place, and that means the nurses are then free to look after the patients on the wards,” he added.

Chris Hopson concluded: “What we can say with confidence is that NHS trusts have prepared for the challenge and will do all they can to provide high quality care for every patient, whatever the pressure.”

Have you got a story to tell? Would you like to become an NHE columnist? If so, click here.