A&E IN CRISIS
UP TO 16-HOUR WAIT FOR TREATMENT
THE full scale of the winter crisis gripping Manchester’s A&E departments can today be laid bare.
An internal memo leaked to the M.E.N. shows patients now waiting up to 16 hours to be admitted at casualty, referred elsewhere or discharged as the system buckles under soaring pressure. The briefing, which provides a snapshot of performance at the city’s three emergency departments over the last week, also reveals:
Nearly 200 patients waiting more than an hour to get into hospital in queuing ambulances
Ambulances diverted away from Wythenshawe because of the surge in demand
A dramatic spike after New Year with North Manchester’s A&E up to 98 per cent full
Waits so long units ‘unable to deliver comprehensive care’ due to demand
90 people a day stuck in hospital due to a lack of social care
The leaked memo details figures for all three Manchester A&Es in the week to Wednesday – and follows a warning from the region’s health chief Jon Rouse that our hospitals are ‘very close’ to full.
Soaring demand, flu and norovirus outbreaks and a lack of social care have combined to put A&Es under unprecedented strain, leading NHS England to recommend all non-urgent elective operations be postponed.
The briefing shows all three of the city’s three hospitals – Manchester Royal Infirmary, Wythenshawe and North Manchester General – have followed that advice, cancelling operations until at least the middle of January.
Both North Manchester and Wythenshawe’s A&Es are under particular pressure, it reveals.
Waiting times at the units have been escalated to ‘OPEL 4,’ Greater Manchester NHS’s most severe pressure category – meaning they are under so much strain health organisations are ‘unable to deliver comprehensive care.’
While government targets expect 95pc of patients to be seen within four hours, Wythenshawe’s figure fell below 49pc on Tuesday and Wednesday.
Ambulances have twice been diverted from Wythenshawe to MRI as a result of demand and on Monday the resuscitation unit was completely full.
Across the three hospitals, 189 patients waited in queuing ambulances over a week.
Meanwhile patients at both North Manchester and MRI waited up to 16 hours to be admitted on Tuesday.
Bed shortages are a key factor in the crisis, with North Manchester’s A&E – which even outside of winter does not have enough beds – reaching 97.7pc full on Tuesday.
Much of the shortage is due to ongoing difficulties in discharging patients well enough to go home.
Around 90 beds a day across the city are currently taken by people who are ready to leave but have no social care to go to - with the numbers running particularly high in Wythenshawe.
Around half those awaiting discharge at Wythenshawe come under Trafford council’s social care system, while most of those at the other two hospitals are Manchester residents.
At the same time infection out-
breaks have shut nine beds at North Manchester and MRI - and across Manchester around 170 patients have been placed on nonmedical wards due to a lack of space.
The briefing shows GPs are increasingly being roped in to deal with patients at MRI in order to take pressure off the department, while social services have stepped up attempts to find care home beds and home care across the city. However, Jon Rouse, Greater Manchester’s chief health officer, warned yesterday that pressures could rise even further during the forecast cold snap.
Dr Chris Brookes, group medical officer at the Northern Care Alliance – which includes Pennine – urged the public to think ‘carefully’ about which service to use.
People with cold and flu-like symptoms should go to their pharmacy or call 111, with A&E prioritising those with critical and lifethreatening conditions, he said, adding: “I would like to reassure the public that we have robust functioning winter plans in place for all our hospitals in Salford, Oldham, North Manchester, Bury and Rochdale, and that patient safety is our priority. I would also like to thank our hard-working staff for going above and beyond the call of duty in many instances to keep our patients safe and well this winter.”
In recognition of the escalating winter crisis, on Tuesday NHS England issued guidance recommending trusts cancel non-urgent elective operations and outpatient appointments until January 31.
When the M.E.N. asked Manchester’s hospitals yesterday whether any operations had been cancelled, neither Manchester Foundation Trust – which runs MRI and Wythenshawe – or Pennine Acute, which runs North Manchester, responded to the question. However, the memo reveals Manchester Foundation Trust has in fact cancelled all such procedures until the middle of this month, while North Manchester has done so until at least January 22.
Dr Brookes added: “We are working hard to minimise any disruption to planned non-urgent operations and outpatient appointments.
“If we do decide to delay and reschedule any non-urgent operations such as hip or knee replacements, we will inform our patients as soon as possible, and alternative appointments will be booked in due course.
“Patients should assume their appointment is going ahead unless they hear otherwise.”