Pressure on our hospitals ‘severe for third of year’

WALES’ major hospitals are under the most severe level of pressure for nearly a third of the year on average, new figures have shown.

Health Secretary Vaughan Gething AM, in response to a letter from the Welsh Conservatives, confirmed 13 hospitals across six health boards spent an average of 107 days in the highest state of escalation.

Welsh health boards have four different levels of escalation which define pressures on emergency services and how hospitals should respond. Level four, described as “extreme pressure”, is triggered when emergency admissions significantly exceed predicted levels and when A&E departments are unable to cope with any further demand.

It also occurs when patients are awaiting transfer from an ambulance into a hospital for more than an hour. Similarly, level four occurs when there is no capacity in the coronary care unit or intensive therapy units and it is not possible to divert patients to neighbouring health boards.

When pressure reaches level four, the health board’s chief executive and the Welsh Government are notified and all “elective activity” – for example non-urgent procedures – are postponed for 24 hours.

Ysbyty Glan Clwyd in Bodelwyddan, Denbighshire, reached level four status on 209 days – the worst in Wales. The University Hospital of Wales, in Cardiff, had 201 days at level four over the same time period.

Angela Burns AM, Welsh Conservative Shadow Health Secretary, said: “These are staggering figures and lay bare the extraordinary pressures faced by frontline Welsh NHS staff throughout the year. Having to operate at such an intensity for protracted periods is neither safe for patients nor fair to staff, many of whom are close to breaking point.

“We need better planning, more recruitment and more beds – all of which have deteriorated significantly under Welsh Labour’s mismanagement of our NHS. Patients and staff deserve so much better.”

Earlier this month, the Royal College of Emergency Medicine described A&E departments across the country as “like a battlefield”.

Commenting on the statistics, the organisation’s vice-president for Wales, Dr Robin Roop, said: “These figures are indeed alarming. But to me and my colleagues working in emergency departments, the findings are unsurprising. Pressure is evident in every medical specialty, in every hospital ward and in every community health and social care service.

“In the emergency department, we see day to day the stress both patients and staff are subject to when ambulances start queuing outside and waiting times start to climb.

“Staff are extremely concerned that patient safety is increasingly being compromised – a trend that is likely to continue if we do not act now.

“There are no quick and easy solutions to solve this. We need to think long-term and plan now for the larger, older population of the future. This means that we are going to need investment in staffing, hospital beds and social care to rescue a system that cannot continue on this path.”

Royal College of Nursing in Wales’ associate director (professional practice) Alison Davies said the figures highlight the fact NHS pressures are all year round.

She said: “Nurses and healthcare support workers are working exceptionally hard for prolonged periods, in very difficult circumstances and tell us they are concerned about growing pressures on them and other professionals that make it increasingly difficult to provide safe care to people who need it.

“The problems we are seeing at the moment are a symptom of fundamental challenges across health and social care, which need to be addressed. We need enough nurses with the right skills in the right places at the right time, to ensure that people receive high-quality care.”

Dr David Bailey, chairman of BMA’s Welsh Council, said: “Doctors and other healthcare professionals are faced with exponential pressures; too many beds have been cut, there are inadequate resources and the workload is unsustainable.

“There is a constant pressure on emergency departments, further compounded by inadequate investment in social care, which creates difficulties in moving people out of hospitals and back into their homes.

“These figures demonstrate the need for long-term, sustainable solutions in the Welsh NHS that address the growing gap between demand for services and the resources available to deliver them.”

A Welsh Government spokesman said: “We have been open about the challenges that NHS Wales and emergency departments are under, this is not unique to Wales.

“The escalation levels are not designed as a performance measure, they are an internal tool to aid the management of patients through the hospital system and the levels change throughout a day.

“While there are particular pressures on some emergency departments in Wales, through the appropriate use of escalation measures and good planning these have eased in recent days.

“However, we are not complacent and are acutely aware the situation could escalate again very quickly, in particular, as a result of the combined effect of flu and cold weather.”