‘Extreme pressures on NHS for third of year’
THE relentless pressure on Wales’ major hospitals has been laid bare in sobering new figures from Health Secretary Vaughan Gething.
Following a request from the Welsh Conservatives, he revealed that hospitals operated under “extreme pressure” – the most severe escalation level – on 107 days over a one-year period on average.
Ysbyty Glan Clwyd in Denbighshire was the most likely to be under the highest level of demand between November 2016 and October 2017.
The Royal College of Emergency Medicine has described the figures as “alarming”.
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 that 13 hospitals across six health boards spent on average 107 days each 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 – is postponed for 24 hours.
Ysbyty Glan Clwyd in Bodelwyddan, Denbighshire, reached Level Four status on 209 days between November 1, 2016 and October 31, 2017 – the worst in Wales. University Hospital of Wales had 201 days at Level Four over the same time period, followed by Ysbyty Gwynedd (179) and Swansea’s Morriston Hospital (153).
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 that the NHS is under pressure 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.
“There needs to be continued investment in more nursing staff across the whole healthcare system, including in the community, to ensure that, wherever possible, people can be cared for in their own homes, including care homes.”
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 spokesperson 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.
“The Welsh Government is aware of the challenges Betsi Cadwaladr are experiencing and we continue to support them through the ‘special measures’ arrangements in place to deliver the improvements required, with a particular focus on hospital discharge and escalation.
“We continue to be grateful to staff across Wales in health and social care for their dedicated and professional work in dealing with large numbers of patients throughout the year and we are working hard to support them.”