Persistent bed blocking has added to the delays facing patients in the Accident and Emergency (A&E) Department at the Royal Sussex County Hospital.
The trust that runs the Royal Sussex, in Brighton, said: “On average, we have been caring for more than 300 medically ready for discharge patients a day – and sometimes many more”
The figure – in a report by chief executive George Findlay – covers all the hospitals run by University Hospitals Sussex NHS Foundation Trust.
But the Royal Sussex is understood to be one of the worst-affected hospitals in the trust, partly because it is also the biggest.
Work is under way at the Royal Sussex A&E, with £50 million being spent on modernising the area and creating more space for patients to be assessed and treated.
The changes should also improve the experience of patients who arrive by ambulance.
Some of the money will also enable an expansion of the medical assessment unit over the next three years and changes to the surgical assessment unit aimed at improving “patient flow” through the hospital.
Dr Findlay set out some of the challenges facing the trust at a board meeting this morning (Thursday 2 May).
He said: “The past three months have been characterised by an unseasonal extension of winter pressures into spring, with all our hospitals continuing to operate either at – or even above – full capacity for prolonged periods.
“Consequently, we have had to call ‘business continuity incidents’ on several occasions at each of our main hospitals to redirect resources and call upon greater support from system partners to help more patients leave hospital in a safe and timely manner.
“While we have seen an increase in attendances at all our emergency departments, more significant has been the growing proportion of acutely unwell people who have needed urgent admission on to a ward.
“At the same time, an unsustainable number of our beds have been occupied by patients who are medically ready for discharge but who are unable to leave hospital while they are waiting for non-acute care elsewhere to be arranged or become available.
“On average, we have been caring for more than 300 medically ready for discharge patients a day, and sometimes many more, which is the equivalent to more than 10 full wards that need to be staffed and resourced despite their patients no longer requiring acute hospital care.
“Sadly, this has resulted in longer waits in our emergency departments recently due to beds not being available when they are needed most.
“We deeply regret how this has affected patients and I wish to apologise to anyone who has experienced this in recent months.
“We are working extremely hard to address the problem, with high-profile improvement programmes to ensure we are doing all we can to improve flow through our hospitals, and by working very closely with our system partners – but they too are experiencing significant systemic pressures.
“At the beginning of April, we also had to declare a ‘critical incident’ when a highly contagious strain of a diarrhoea and vomiting bug circulating in the Chichester area led to an outbreak at St Richard’s Hospital at a time when the hospital was already operating at full capacity.
“Several wards were closed, visiting suspended and ambulance diversions put in place to Worthing Hospital and Princess Royal A&E units.
“I am hugely grateful for the support of colleagues in these hospitals, as well as the way everyone at St Richard’s responded to the incident.
“Their efforts were acknowledged by an outpouring of supportive and kind messages on social media.”
No doubt the larger holdup in discharging them is due to the lack of provision of social care that is supposed to be provided by the council.
The council seem more preoccupied with vanity projects and not core services. The 6 million and rising of BHCC council tax earmarked for VG3 would buy some care would it not.
On the other hand – does the new hospital no have substantially more beds than the old one ?
Ah, you know that money couldn’t be used in that fashion, Chris. I think it would be more prudent to focus more on community-based services. Treatment at home where possible, expanded remits of Pharmacists, and greater utilisation of Paramedics in GP surgeries, are all ways we can prevent people from ending up in hospital in the first place.
Well yes and no. I am talking about the 6million of council money that is earmarked to fund the difference between the grant and the actual cost of a very controversial development.
That’s fair. Social Care is one of those things that can easily swallow the entire budget.
Sadly, the perception of there being a lack of social care provision is incorrect. There is plenty of home care capacity within the City. I suspect between all of the care providers in Brighton, the majority of the medically fit patients could be discharged and be cared for at home within the next week. Literally, that fast!! The issue is the local authority choosing not to cast their net wider to find available capacity outside of their usual LA care providers. It comes down to cost, with the LA choosing not to pay slightly higher rates, but instead choosing to leave these patients in hospitals, probably deteriorating, and heaping the cost of caring for these people on the NHS. It’s not rocket science! Pay a few more pounds for each patient in the community and free up £300+ per day for every bed taken up. Can someone please do the calculation for the LA and NHS, ask them to communicate with each other and get things moving!!
That’s not sustainable at all, just from a financial point of view.
Neither is allowing people to die due to lack of access to healthcare because of separate budgets. Perhaps social care should be managed by the NHS not councils who could be a little more joined up
Morbidly, fewer people would be more sustainable, although morally massively draconian. I’d welcome some more joined-up thinking when it comes to social care. It’s a change I was positively keen to see in the upcoming cabinet restructure.
NHS are quite infamous for being rather poor in managing finances and being efficient. Flat rate prescriptions, for example, could cut an entire department out of NHSBSA, and remove the need for exemption checking. For the price of £1 per item, the NHS would earn more money as well overall.
Joined up thinking in realtion to budgets is definitely something that needs to happen. It’s actually the NHS that are currently pushing this agenda in relation to hospital discharges. It is the LA that are failing to grasp the physical and financial benefits of getting people home more quickly. Not only are the extended NHS costs unnecessary and unsustainable, but the physical decline of a patient is morally unacceptable!