NHS delays left patients stuck in A&E for Christmas AND Boxing Day

Twenty-hour waits left patients stuck in A&E for Christmas AND Boxing Day amid bed blocking crisis that led one ambulance service to declare a critical incident

• Some Britons were forced to spend the festivities stuck in A&E in 20-hour waits
• Pressures are the latest sign the UK’s bed blocking crisis has yet to be resolved 
• Ambulance service declared critical incident today due to A&E handover delays
• Comes as Wes Streeting defended Labour plans to use private care to help NHS

Some patients were stuck in A&E for both Christmas and Boxing Day due to 20-hour waits for a bed, a doctor has revealed.

Unwell Britons faced delays of almost a whole day due to a lack of available beds across hospitals in England and Scotland, the frontline medic NHS said.

The bed blocking crisis — caused by delays discharging healthy patients — also saw one ambulance trust declare a ‘critical incident’ today because staff were stuck outside of hospitals unable to hand over patients and respond to other 999 calls.

Meanwhile, Labour’s Shadow Health Secretary called for the NHS to ‘reform or die’ as he defended proposals to use private hospital capacity to ease pressure on the health service.

Some patients have been forced to spend both Christmas and Boxing Day in A&E due to extraordinary 20-hour waits to be seen, one medic has said. (image taken at The Royal London Hospital on December 21)

A&E performance has worsened in November, with a third of emergency department attendees not seen within four hours (red line) — the NHS’s worst ever performance. Thousands weren’t even seen after waiting in casualty for 12 hours (yellow bars)

More than 7.2million patients in England were stuck in the backlog in October (red line)— or one in eight people. More than 400,000 have queued for at least one year (yellow bars)

The NHS’s bed-blocking crisis has exploded since the pandemic with the levels of delayed discharges around triple comparable figures before the pandemic

Ambulances took an average of 48 minutes and eight seconds to respond to 372,326 category two calls, such as heart attacks, strokes burns and epilepsy (red bars). This is nearly three times as long as the 18 minute target but around 13 minutes speedier than one month earlier

Nearly one hundred hospitals are dealing with fewer Covid patients than so-called ‘bed-blockers’, according to ‘worrying’ official figures. Map shows: The 10 hospitals with the most patients medically fit for discharge that were still in beds in the week ending October 31

Bed blockers

Some 13,000 hospital beds across the country — or one in seven — are currently filled with patients declared fit for discharge. 

The figure is triple the pre-pandemic average.

And there is huge variation across the country. In London, half of patients were discharged on time but the figure was as low as 28 per cent in the North West. 

Experts say the numbers are being driven by a separate crisis in social care, leaving patients left to languish on wards for up to nine months because there is no suitable nursing accommodation or care available for them in the community. 

The lack of beds has seen ambulances stuck in queues for 20 hours outside of hospitals this summer, as emergency medics scramble to find beds for patients. This is had a knock-on effect on response times. 

Workforce shortages

The NHS, which employs over a million people, has around 130,000 vacancies across its entire workforce.

This reduces productivity, with too fewer staff to carry out appointments and procedures.

Health chiefs also warn that it stops staff from delivering high-quality care and can lead to safety concerns if too few staff are working.

In turn, medics are at a higher risk of burnout, illness and early retirement due to these factors. 

Surge in seasonal viruses 

More than 1,000 beds per day are taken up by patients severely unwell with seasonal viruses. 

NHS data shows Britons sickened with influenza occupied 712 beds, on average, each day last week. Flu levels are much higher than this time last year.

Meanwhile, norovirus accounted for 318 taken beds per day and RSV saw 132 occupied. 

Strep A fears

Nine children in the UK have died in recent weeks due to an outbreak of Strep A.

The bacterial infection is harmless for the vast majority. But it can cause life-threatening illness if the bacteria invade the blood, muscles or lungs.

Doctors have warned that A&E, GPs and ambulances are in meltdown due to a surge in demand from parents worried that their child is infected.

Patients have faced longer emergency department waits, while some hospitals have postponed routine procedures to cope with demand.

Covid pressures

Around 4,700 beds per day were occupied by a patient infected with Covid in the week to November 30.

Two-thirds were primarily admitted for another ailment, such as a broken leg, but happened to test positive.

However, infected patients still pile pressure on the health service as they have to be isolated from others.

The virus also contributes to higher rates of staff sickness.  

GP appointment crisis

Campaign groups, MPs and senior medics say desperate patients are turning to emergency and walk-in services because they can’t get a face-to-face appointment with their GP.

The average GP in England is responsible for 2,200 patients now – up from 1,900 in 2016. 

In the areas with poorest access, up to 2,600 patients are fighting over one family doctor.

The Royal College of Emergency Medicine (RCEM) has previously warned difficulties in seeing a GP was leading to a crisis in emergency departments.

On top of usual winter pressures on the NHS, the health service is also facing record demand in emergency care and a surge in influenza cases.

Further adding to the crisis is the fact that 13,000 hospital beds — around one in seven — were taken up by bed-blockers at the start of the month, which is the latest available data.

The figure is triple the pre-pandemic average. 

Experts say the numbers are being driven by a separate crisis in social care, leaving patients left to languish on wards for up to nine months because there is no suitable nursing home accommodation or care available for them in the community. 

The lack of beds saw ambulances stuck in queues for 20 hours outside of hospitals this summer, as emergency medics scrambleld to find beds for patients. This has had a knock-on effect on response times.

One senior medic in Scotland told The Times that patients on both sides of the border were suffering from a lack of beds. 

‘Patients are still facing 20-hour waits before we can find them a ward bed,’ they said.

‘It is that way in a number of Scottish hospitals and it will be the same in parts of England as well.’

NHS performance was already plummeting before winter pressures kicked-in, with trusts logging the worst ambulance response times, A&E waits and queues for treatment ever in recent months. 

And the festive period does not seem to have brought any relief, with the North East Ambulance Service (NEAS) declaring a ‘critical incident’ today due to pressure on its services.

The service operates across Northumberland, Tyne and Wear, County Durham, Darlington and Teesside. 

The NEAS, which has more than 2,500 staff and serves a population of 2.7million people, said more than 100 patients were experiencing ‘significant delays’ for an ambulance.

Part of the reason for the build-up was due to paramedics being unable to respond to 999 calls ‘because of delays in handing over patients at the region’s hospitals’, it said.

NEAS strategic commander Shane Woodhouse said: ‘This is the second time in nine days that we have declared a critical incident due to the unprecedented pressure we are seeing across the health system.

‘Declaring a critical incident alerts our health system partners to provide support where they can and means we can focus our resources on those patients most in need.’ 

He urged people to only call 999 in a life-threatening emergency adding that the service would be asking some patients to transport themselves to hospital if safe to do so. 

Long waits for ambulances and in A&E have become increasingly common. 

The latest NHS data shows ambulance response times are more than double the target for some emergencies.  

Ambulances took an average of 48 minutes and 8 seconds to respond to category two calls, such as heart attacks, strokes, burns and epilepsy in October. 

This is nearly three times as long as the 18-minute target average response time target set by the NHS.

A&E waits have also skyrocketed, with data for October showing that a third of emergency department attendees in England were not seen within four-hours, marking the health service’s worst ever performance in this metric. 

It comes as NHS England set hospitals a new objective of seeing only three-quarters of A&E patients within four hours, an effective downgrading of the official target of 95 per cent of patients being seen in this time. 

NHS England bosses told hospitals they should aim to see 76 per cent of all patients within four hours by April 2024.

Planned care in the NHS, such as knee and hip replacements, has also suffered. The number of people queuing for routine treatments such as these has reached 7.2million. The figure stood at 4.4million before the Covid crisis hit.

The Government has dished out extra cash to hospitals this winter to boost bed capacity and provide more support to patients in the community. 

And it has set up dozens of diagnostic centres across England in the hopes of bringing down waiting lists. 

Ministers also set up a taskforce to look at ways of using spare capacity, such as beds and operating theatres, in the private sector in the hopes of treating patients stuck in the backlog more quickly. 

Labour’s shadow health secretary Wes Streeting was today forced to defend his party’s plan to use the private sector to help tackle this backlog. 

Mr Streeting, standing in as a presenter on LBC, said the NHS must ‘reform or die’ as he acknowledged his contentious plan.

He said: ‘This has caused some controversy, including on my own side, that as a short-term measure to deal with the NHS crisis I would be prepared to use the private sector to bring down NHS waiting lists faster. 

‘We know that there’s spare capacity there. And I don’t think that people should be waiting longer while those beds exist.’

While insisting he was still opposed to privatising the NHS, he added: ‘I’ve been pretty blunt about the fact that I think the NHS needs to reform or it will die.’

His comments come just a few weeks after ex-Health Secretary Sajid Javid said the NHS — which has an annual budget of £150billion — ‘won’t survive many more years’ without huge reform and said the nation should have an ‘honest debate’ on next steps for British healthcare.

Matthew Taylor, chief executive of the NHS Confederation, joined Mr Streeting on the programme.

He said: ‘The challenge for you, I think, is that we need a short-term plan for recovery in the health service and a long-term plan for transformation in the health service. 

‘And we’ve got to recognise that the danger is that all the time we crisis manage.’

He added that while the NHS had to recover, a ‘long-term vision for a sustainable and much better health system in the future’ is also required. 

In other news…

Doctors call for sugar and salt limits in baby food as they warn future generations are ‘at risk’ due to ‘nutritional lucky-dip’ that sees some products packed with more sugar than COCA COLA 

Nearly two-thirds of junior doctors are ‘looking to leave the NHS’, union warns ahead of industrial action ballot 

Once a month jab could ease pain of arthritic knees: More than 600 people with knee osteoarthritis are taking part in clinical trials of the drug 

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