A predictable surge in norovirus is plunging Emergency Departments further into crisis because of a failure to prepare for winter.
That is the Royal College of Emergency Medicine’s key takeaway from data published by NHS England today (29 January) on winter pressures facing the health service.
Today’s data, from NHSE’s latest weekly winter situation report, covers the week ending 25 January.
It showed that bed occupancy in English hospitals remains dangerously high, at 94.6%, while more than 14,000 people medically fit to be discharged from hospital were still stuck in beds.
On a given day, there were on average 50,368 patients who had been in a hospital bed for seven days or longer, showing problems lie at the ‘back door’ of hospitals.
Meanwhile, a seasonal surge in Norovirus (also known as Diarrhoea and Vomiting, or D&V) continues. The number of general and acute beds occupied by patients presenting with it averaging 1,106 per day, 122 more than the daily average for the previous week.
That week alone, 45 patients were diverted from one A&E to another for a total of 343 diverts across this winter so far – a far higher rate than recent years.
Typically, a patient is only diverted to a different department as a last resort, often because one ED is completely overwhelmed.
Meanwhile, the average time it takes to handover a patient from an ambulance to an ED improved slightly on the previous week, with just over one in three handovers taking 30 minutes or more.
Dr Ian Higginson, RCEM President, said: “None of the pressures we are facing this winter were unexpected or surprising, and yet we are at breaking point.
“We are not being overwhelmed by unprecedented numbers of patients arriving in hospitals.
“It’s simple: not enough has been done to tackle exit block in hospitals, where patients who are medically fit to leave a bed are not discharged, through no fault of their own.
“Social care, and wrap-around services, which allow for timely discharges are in desperate need of support and resources.
“The consequence of this is patients lining the corridors of EDs in unacceptable conditions because there are no beds in wards for them to be admitted to. When this happens, they don’t get better: they get sicker.
“Congestion in the hospital system means we are simply not ready for surges in norovirus, flu or major incidents – which we know can and will happen, particularly in winter.
“A failure to prepare properly is to prepare for failure, and that is exactly what happened ahead of this winter. We acknowledge the efforts made by NHS England, but these stats make clear it hasn’t been enough.
“Tackling patient flow must be the top priority for NHS leaders and the government, along with a credible, long-term, plan targeted at bringing down bed occupancy.
“Without this, patients, and the clinicians treating them, will continue to suffer.”
