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Derby and Burton hospitals could be overwhelmed by four wards’ worth this winter

today14 September 2022 1

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Derby and Burton’s hospitals could be 190 beds short of the space they need to treat patients this winter, with NHS services already under immense strain. Unlike in a typical winter period, NHS services cannot entertain the prospect of suspending routine surgeries and treatments to ensure emergency and cancer cases are handled.

This is due to the huge backlog in patients who have been waiting for care for up to two years as a result of the pandemic, during which routine operations have at times been suspended and patients have opted to avoid health facilities due to the perceived risk. Derbyshire health leaders have urged residents not to visit a hospital unless it is absolutely necessary, advising about other options including urgent treatment centres.

All of this comes at a time when NHS services continue to try to wade through the backlog in care and loss of staff due to sickness and postponed retirements, with the system facing a staffing crisis. Staff are exhausted and burned-out but the demand for care continues to sit way above pre-pandemic levels.

Predictions from the University Hospitals of Derby and Burton NHS Foundation Trust show that they expect to be short of between one entire ward’s worth and four wards’ worth of beds over the course of this winter. This stretches from 35 beds short in December to 106 beds short in January.

More pessimistic modelling from the trust shows that it could be short of 190 beds (in excess of six entire wards) in January with gaps of 100 beds or more from now through to March – with the trust not forecasting further than March 2023. Board papers from the trust detail:”In recent winters, elective activity has been reduced to support outlier capacity for increased non elective admissions.

“Following the Covid-19 pandemic, associated increases in waiting list size, waiting times for elective procedures and the elective/cancer recovery plan it requires the protection of elective bed capacity if further increase in waiting is to be avoided and quality of care is maintained for all patients.” It has assessed the predicted situation at winter and has found “modelling does indicate that demand will be greater than capacity, impacting particularly on the emergency department and specialities within medicine”.

The trust is “anticipating” a resurgence of contagious infections flu, norovirus and respiratory syncytial virus (RSV), leading to increased admissions and attendances at A&E. It also is aware of a “potential surge in Covid-19 prevalence which may impact on acute care demand, workforce availability and elective recovery”.

The organisation says isolation requirements for patients who test positive for Covid-19 will impact on available bed capacity. On workforce, the trust says: “The challenges of the Covid-19 pandemic have had a significant impact on our people.

“There are established vacancies and challenges with recruitment across the workforce coupled with additional workforce requirements during the winter period. Winter illnesses will also impact on the workforce availability. The availability of all staff groups but especially senior decision makers in particular impacts on management plans and can lead to delays.”

A Joined Up Care Derbyshire spokesperson said: “Winter is always a busy time for NHS services and brings additional challenges and a growth in demand for urgent, emergency, and critical care services in addition to specific winter illnesses and challenges associated with adverse weather. To meet the additional demand and to mitigate risk, we are putting plans in place to deliver safe and effective care which puts our patients and communities first and enables the right care to be delivered.

“As part of those plans, we will continue to work in collaboration with system partners to ensure our patients and communities are able to access services appropriate for their needs and enable them to access the services they need when they need it the most. At this time of year, we often ask patients to make wise choices, which is especially important this year. We want to stress the vital role that you can all play in helping us by choosing the right NHS services for you this winter.

“People can help us do this by using the NHS 111, either the online service or by calling 111 for advice on non-life-threatening concerns. They can also visit an urgent treatment centre, where staff can provide treatment and advice for minor injuries or illnesses.

“It is absolutely crucial that anyone who does not need to be in a hospital setting, does not attend, as we must be able to focus our attention on the increasing numbers of very poorly patients.” In relation to Covid-19, the trust has detailed that of the course of the pandemic 1,854 patients have contracted the virus while in the hospital for another ailment.

It says 435 of these incidents have occurred since April this year. In regards to Covid outbreaks at the hospital trust, the organisation says there were eight outbreaks in July and five in August, with 1,362 patients and 686 staff affected by Covid outbreaks within the hospital trust since the start of the pandemic.

The organisation says in board papers that: “The sources of outbreaks are asymptomatic, wandering positive patients and visitors not wearing masks whilst in wards.” It also says that infections contracted in the hospitals and outbreaks can be linked to “overcrowding in the waiting areas in the emergency departments during busy times”.

Ventilation is a key issue which the trust is aware of, but it says some wards do not have opening windows, and where there are windows patients are often “reluctant” to open them on cooler days – “negatively affects air exchanges”. When the Local Democracy Reporting Service asked the trust for comment, Donna Bird, the organisation’s director of nursing, said: “We have seen a reduction in the number of outbreaks since July and that is down to collaborative efforts from colleagues across the trust who continue to do everything they can to keep our patients and visitors safe.

“Many people who test positive for Covid-19 don’t display any symptoms, which is why it is still so important to adhere to the correct mask wearing guidance and other infection prevention measures such as hand hygiene to try and keep infections out of our hospitals.” The trust says in its board reports that there were around 150 hospital patients with Covid-19 in July and in August this dropped to around 50.

In response to the high number of Covid patients in July, mandatory mask-wearing inside all of the trust’s hospitals was reintroduced – two weeks after the requirement had been dropped.

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