Worcestershire Emergency Departments Under ‘Extreme Pressure’

The acute trust in Worcestershire has announced three critical incidents within a three-week period due to “extreme pressure” experienced by the county’s emergency departments. The most recent incident, initiated on Monday, concluded on Thursday. The Worcestershire Acute Hospitals NHS Trust has issued an apology regarding the treatment delays at its Accident & Emergency departments, located in Worcester and Redditch. The Trust reported an increase of nearly 1,000 patients in November compared to the previous year’s same period. Furthermore, the high volume of walk-in patients contributed to extended handover times for individuals arriving by ambulance. Data from October revealed that only 50.6% of individuals visiting the county’s emergency departments received treatment, admission, or discharge within the four-hour target. Concurrently, 1,268 ambulance patients endured waits exceeding an hour outside the facilities. Tim Mason, a walk-in patient, reported waiting over 11 hours in A&E without receiving medication. He stated that there were insufficient doctors and nurses working night shifts. Mr. Mason commented, “A and E was appalling… I’ve got to question what their staffing levels are out of hours.” Mr. Mason had presented at Worcestershire Royal Hospital at 22:00 GMT on 12 November, suspecting deep vein thrombosis due to severe pain and swelling in his leg. He described the situation, saying, “It was a very, very busy night… I had to sort of sit on the floor in the waiting room.” Following an initial triage by a nurse, Mr. Mason recounted waiting five hours for a blood test. He then waited a total of 11 and a half hours before being admitted to the department’s Same Day Emergency Care [SDEC] unit, where he eventually received treatment. He further stated, “They were absolutely fantastic when they realised I hadn’t been given any blood thinners… within one minute I was having a heparin injection.” Observing other patients waiting in the emergency department throughout the night, Mr. Mason expressed doubts about the hospital’s out-of-hours capacity. He remarked, “My feeling was that A and E were just sitting on patients, not really treating them… just waiting for the magic time to come at 8am, where different departments would be open.” Mr. Mason reported returning to the same emergency department two days later due to recurring pain. Despite requesting the NHS 111 service to directly refer him to the hospital’s SDEC unit, he indicated that he still faced hours of waiting for treatment. Stephen Collman, the managing director of Worcestershire Acute Hospitals NHS Trust, offered an apology for the prolonged waiting times at its A&E departments. He explained that the critical incidents were announced due to “continuing, extreme pressure on our hospital sites.” The declaration of a critical incident enables a hospital to allocate additional resources, including more clinical personnel dedicated to patient discharge, and to seek assistance from other healthcare facilities like community hospitals. Mr. Collman stated, “Our teams are continuing to work hard, alongside our partners across the wider health and care system, to reduce the pressure on ED [emergency departments], and ensure patients get the care they need.” He additionally advised patients to utilize the NHS 111 service prior to visiting A&E, unless their condition constituted a life-threatening emergency. He further noted, “Remember that local Minor Injury Units can treat a variety of injuries including wounds, sprains, strains and minor burns with much shorter waiting times.” November statistics indicated that the number of visits to the county’s emergency department increased by 9.6% compared to the corresponding period in 2023. Senior management voiced their concerns during a trust board meeting held on Tuesday. Chris Douglas, director of performance, commented, “That equates to almost 1,000 attendances more… these are not insignificant numbers.” He also stated, “We have had up to 43 patients in spaces that we don’t routinely put patients.” Mr. Douglas mentioned that escalation procedures were implemented following an incident in October where 36 patients waited over eight hours in ambulances for handover. Beyond the rising demand, A&E personnel have encountered additional difficulties. Due to flooring repairs at the Worcestershire Royal’s new £35m emergency department, patients were distributed across two floors during October and November. Management also indicated that the implementation of a new electronic patient record system last month negatively impacted productivity. Sarah Shingler, the chief nursing officer, reported that the provision of care in corridors and general overcrowding contributed to a rise in patient falls. Mr. Douglas stated that an audit of A&E patients is currently underway, aiming “to understand where else patients have already tried, and what have been the blockages.”