Trust and patients left counting the cost of the winter crisis

THE winter crisis which gripped the NHS saw 32 cancer patients have operations cancelled in Leicestershire.

The postponing of all non-urgent operations also left a £10million hole in hospital finances a health scrutiny committee heard.

Detailing the difficulties faced by hospitals in the county, Tamsin Hooton, director of urgent and emergency care at Leicester, Leicestershire and Rutland Clinical Commissioning Groups, said high bed occupancy had led to cancer operations being cancelled.

She told the Leicestershire County Council health overview and scrutiny committee: “In terms of how the winter has progressed I think it has been very challenging.

“Particularly over Christmas and New Year week we experienced a different profile of attendances and pressures than anticipated and compared to the activity last year we used to feed into our plan.

“What we normally experience going into Christmas there is an increase in discharge rate that enables people to go home and provides spare bed capacity...despite some really intensive efforts in the second half of December we didn’t experience that this year.

“I was on call on Christmas Eve and I’ve never known a hospital full on Christmas Eve but that’s what we had at LRI this year, that put us in a bad place to face Christmas and new year and it’s been a difficult few weeks and months.”

Ms Hooton said the reasons for high occupancy included the presentation of patients with respiratory type illnesses which led to longer hospital stays.

Stranded patients, with nowhere else to go, also prevented beds being freed up.

She added: “It’s been a really difficult January and February.

“This year we’ve experienced the need to cancel more patients than previously, part of that driven by a national directive that elective activity should be stepped down to a greater extent than we would do normally.

“Over and above that the levels of occupancy and pressures on ITU and recovery beds has meant a number of patients who have urgent treatment needs, including some cancer patients, have been cancelled in LLR.

“That’s something that’s really regrettable and is not done lightly but in response to capacity pressures, but that is unusual for us as a system.”

She told councillors 32 cancer patients had treatment cancelled in the first eight days of January because there were no available beds in the intensive care unit or in the recovery unit.

All went on to have rescheduled treatment before the end of January.

Mark Wightman, director of communications and external relations at University Hospitals Leicester, said operations were not cancelled lightly.

He said: “Nobody enjoys cancelling a patient.

“Just before New Year NHS England wrote to every acute trust essentially saying take down all of your non-urgent surgery because they were getting increasingly worried by reports coming in from across the country showing flu was spiking and bed occupancy was up in the region of 95 per cent.

“So essentially take down all non-urgent surgery to cope with urgent and life threatening.

“To put it into perspective why we don’t like to cancel; for an acute hospital everything coming in on an emergency pathway costs an awful lot of money, more money than it takes to look after them.

“The only way to keep afloat is to do elective work.

“The elective work cancelled during January, after considering the impact on patients, cost the trust and its bottom line somewhere in the region of £10 million.

“That is essentially just the cost of cancelling the electives given January is one of the busiest periods.

“Unlike businesses in other sectors, we can’t flex our workforce so all of the costs are there essentially.

“All the staff, all the theatres,

“It’s just the fact most of those staff were working on the emergency pathway.

“Some of our orthopods doing hips knees and elbows, unless it was an emergency hip fracture, may not have operated for four to five weeks so some of our most expensive resources is stood down.

“That’s not exclusive to Leicester, that’s just the impact of trying to cope through a particularly difficult winter with a particularly difficult flu.”