Patients not turning up for operations, an increase in respiratory illnesses and delayed discharges – as well as the misuse of A&E – all make winter more difficult for the region’s NHS.
That’s the message from consultants, nursing managers, pharmacists and pathologists based at The James Cook University Hospital in Middlesbrough, who are appealing for the public’s help to ease winter pressures at South Tees Hospitals NHS Foundation Trust.
Staff across the trust joined forces for a series of videos assuring patients it is prepared for winter – at the same time as highlighting how the public can help with its inevitable winter pressures.
These include an increased number of children coming into hospital due to higher incidences of lung condition bronchiolitis, resulting in children and babies needing emergency support to help them breathe.
Mike Tremlett, consultant paediatric anaesthetist, said: “What adds pressure to us from the perspective of children is that there are two big groups, medically ill children who commonly come in with infections at this time of year and the emergency group.
“Set against that, we also have planned surgery patients and a significant amount of children coming in needing help with their breathing because of bronchiolitis.”
This highlights the wider problem of the trust’s planned – or elective – surgery cases coming under pressure, as emergency admissions take precedence.
However, 1,600 of the 36,000 elective surgery cases the trust plans every year are cancelled because patients simply fail to turn up for their operation – or give less than 24 hours’ notice when circumstances mean they can no longer meet their appointment.
This only adds to the pressures on planned surgery cases that winter brings to the trust, as Stuart Finn, directorate manager for theatres, explains.
“It’s a huge problem,” he says, explaining that patients simply not attending or cancelling their surgery at the last minute accounts for 46% of all cancelled operations.
“If you are planning on not attending, or you can see a change in circumstances that will mean your surgery can’t go ahead, get in touch with us with plenty of notice so that we can admit another patient who is equally in need of their operation in your place.”
Ann Marie Hall, head of nursing, surgical services, adds it is also important to ensure patients are discharged in a timely fashion once they have had their surgery and are well enough to go home or into a community care setting.
She said: “We take patients in from multiple places including the high dependency unit, A&E, directly from GPs and elective surgery patients. “We need to fit all of those people onto our wards and in order to get people in, we need to get people out.
“We try our hardest to ensure that we get patients in the right place at the right time and part of that work is about discharge. That’s why we have an emphasis on trying to discharge patients before midday.”
Relatives can help by ensuring their loved ones who have been in hospital are picked up as early as possible on their day of discharge.
Meanwhile, the trust has also invested in seven mobile pharmacy dispensing carts.
Claire Harding, pharmacist, explains: “This speeds up the discharge process and helps with winter bed pressures. Pharmacists can also give patients advice about their new medicines and an opportunity to ask questions, which also improves patient safety.”
Ian Blain, consultant in emergency medicine, also reminded patients the A&E department will always prioritise the most seriously ill and injured first – and those with minor illnesses or injuries could be seen more quickly by calling NHS 111, visiting GP walk-in centres like The Resolution in North Ormesby or Eston Grange Healthcare Centre in Normanby Road – or using Redcar Primary Care Hospital’s Minor Injuries Unit.
He said: “Winter is always a difficult time for the trust and we would encourage people with minor illnesses to go elsewhere.”