Cancelling ops is last resort amid high alert level, say NHS chiefs
DERBYSHIRE health leaders stress that operations are being cancelled only as a “last resort” after moving to the highest level of alert due to widespread pressure.
They say that the current high alert, for the whole Derbyshire health system, also showcases that this winter will present a “huge challenge” for NHS services.
Patients are being asked to help out by ensuring they go to the right port of call for their ailments, instead of heading to A&E for minor illness or injury.
They also reiterate that Covid is very much “still a threat” despite high levels of vaccination, while also urging for residents to take up the flu jab - and Covid booster jab if they are offered one.
Leaders say that wards that had been converted purely for use by an influx in Covid patients in previous waves, which have returned to their primary use, are on standby again heading into the winter.
Gavin Boyle, chief executive at the Royal Derby Hospital and Queen’s Hospital in Burton, said there is “unprecedented” demand on health services at the moment, with emergency departments under “significant pressure” usually not seen outside of winter.
He said: “This week, we have over 70 patients with us with Covid-19 – the numbers have risen slowly over the last few weeks. This presents challenges to us as we work to meet the general emergency demand and address the backlog of planned treatments which developed during the pandemic.
“The vaccine is clearly working though. These are relatively low numbers given the level of community infection. Also, the patients are generally less poorly than before.
“However, the vaccine is not a guarantee and so taking sensible precautions, particularly in enclosed public spaces, is still vital. We are keeping most of our controls in place for the foreseeable future.
“With the virus still in high circulation and schools returning, we anticipate that the pandemic will be a significant factor through the autumn and winter.
“We are maintaining our incident response measures so that we can react quickly to changes in demand for our services. This includes the option of reopening intensive care surge capacity used in Wave 2 and redesignating wards for Covid-19 patients if required.”
In a series of joint statements, Angie Smithson and Berenice Groves, chief executive and deputy chief executive at Chesterfield Royal Hospital, told the Local Democracy Reporting Service: “We will do our very best to keep any cancellations to an absolute minimum and will base any decisions on clinical need, assessing each patient very carefully.
“By prioritising the most urgent cases, it will ensure that we can continue to treat our most seriously ill patients in a timely manner.
“Cancelling an operation is a decision we never take lightly. It is disruptive to patients’ lives and means that they must wait longer for treatment.
“However, if it is a choice between ‘routine’ surgery and a lifesaving operation then we must prioritise and put the most urgent cases first.
“Postponing procedures is a last resort to ensure our resources can be prioritised towards those with the greatest clinical need.
“If we all think hard about how we use our health services and get the right health advice from the right place quickly, that will reduce those pressures and put us in a better position to meet those demands.
“Patients can expect longer waiting times when visiting our emergency department which is why we are asking everyone to think about the treatment they need.
“We will continue to do everything we can to keep our services running and meet the increasing demands on them but please be considerate and use all NHS services wisely.
“GPs are open and pharmacies can help with advice and give many over the counter solutions to colds, tummy troubles and rashes.
“Our urgent treatment centres are a good alternative to A&E if your injury is not life-threatening.
“They can treat you for serious conditions such as minor head bumps and suspected broken bones.
“To help the flow of patients through our hospital, we need to make beds available as soon as possible. We would ask everyone to ensure they make all practical arrangements for their loved ones to return home or to their place of residence as soon as they have a discharge date.
“This means making sure beds are made, homes are ready, food is in the fridge and that you are able to check in on them as they readjust to being home. Any delays to discharge means a delay in making a hospital bed available, which affects our ability to treat patients.
“We are under no illusions that this Winter represents a huge challenge to the NHS across all services. Covid-19 is still a threat to health, the flu vaccination programme is being rolled out and we are still dealing with a backlog of appointments and operations.
“Therefore we need as many people as possible to take up the offer of a flu vaccine, to get their Covid booster when it’s offered, use services appropriately but seek health advice quickly before it becomes serious.”
The current issue, which is leading to hospital staff having to be redeployed and the cancellation of some operations, has been caused by a litany of issues.
There are more than 70 Covid patients at Chesterfield Royal, the Royal Derby and Queen’s Hospital in Burton, up 50 per cent on the number two weeks ago.
At the same time, “exhausted” and “burned out” staff are wading through a crippling waiting list backlog, with thousands of patients now having waited more than a year for treatment, when usually no patient would wait that long. Staff are also being depleted through contracting Covid themselves.
A&E attendance at our hospitals is as high as it usually reaches in the winter, and in some instances, leaders say, this includes people attending for coughs and colds – which can be treated elsewhere.
Ambulance staff are also reporting much higher volumes of callouts double what would normally qualify as a “challenging” day, this has included hours of additional waits outside hospitals due to transfer delays on pressured hospitals.