A&E attendance at North East hospitals rose sharply in March as winter-style pressures continue to put strain on the NHS.
In Newcastle, city hospitals boss Dame Jackie Daniel said A&E had seen 7% more people through the door than pre-pandemic levels in March - and that when counting just the most sick patients, this was up 21.7%. Around the country it was the busiest March on record for emergency departments, with more than 2.2 million people turning up in need of help.
And the picture is similar across other hospitals in the region. Across five hospital trusts, 91,360 people attended urgent or emergency care services in March - that's the most since October, and that was the busiest month going back to at least 2017, when the NHS began collecting data in this way.
In Newcastle, a total of 21,411 people arrived at A&E across the month - 82.2% of those were seen within four hours, reflecting performance against the target of 95% deteriorating again. No NHS Trust in the UK met this target. At the Royal Victoria Infirmary' s A&E, there were 348 people who were waiting for a hospital bed for more than four hours.
That's up on 116 in February - and only marginally down on the figure of 360 seen in October. At the trust, no patients were waiting for more than 12 hours for a bed.
There was a similar picture seen at the County Durham and Darlington NHS Trust, where 20,856 people came to A&E over March, the highest figure seen since records began. However, for the first month since June 2021 the trust has not seen any patients waiting more than 12 hours for a bed.
However, only 76.2% of patients were seen within four hours - and 1,404 people waited more than four hours for a bed. Despite the high attendance levels, the latter figure has fallen month on month. At its highest last October, 2,258 people waited more than that to be admitted to hospital.
Northumbria Healthcare remains among the NHS trusts with the best performing A&E department when it comes to treating people within target times. 90% of the 19,076 people attending hospital were seen in four hours or less and no patients were waiting more than four hours for a hospital bed.,
In South Tyneside and Sunderland, the figures show that 20,856 people came to A&E in March. Of those, 76.9% were seen within four hours. There was also a rise in those waiting to be admitted to a bed though, with 488 patients in that position, but not waiting more than 12 hours.
At the Queen Elizabeth in Gateshead, there were 9,153 patients through A&E over the month - hospital bosses there have slightly improved the proportion of those seen within four hours, it's now up a single percentage point to 77.3% - however, 943 patients waited for more than four hours and five for more than 12.
Long waits for beds in hospital have a knock-on impact on hospital trusts and the ambulance service - as packed A&E departments make it harder for ambulance crews to pass patients on to hospital staff. This can lead to ambulance crews being forced to wait outside of hospitals, and in the last week in March the Royal College of Emergency Medicine said one in four ambulances around the country had been delayed for half an hour or more waiting to get patients into A&E.
The situation is not as acute in the North East, though on the last day for which winter data was collected - April 3 - there were nine delays of over an hour (six at South Tyneside and Sunderland and three at County Durham and Darlington). There were also 34 delays of between half an hour and an hour across the five trusts. This was around 7% of the total number of ambulance arrivals.
However, on some days in late March and early April trusts saw much higher proportions - on March 31, 35 of 103 ambulance arrivals at Northumbria Healthcare's hospitals were delayed by more than half an hour. Earlier in April, the trust's chief exec Sir James Mackey spoke of how hospital pressures were "really scary". He told a Health Service Journal event it was time to rethink infection prevention rules around Covid-19 and called on local and national government to "pull together" with the NHS.
There are still hundreds of North East patients in hospital with Covid-19. Sir James said difficulties discharging patients from hospital were leading to pressure on "patient flow" and that this impacted on A&E waiting times and ambulance staff being unable to hand-over patients.
He added: "The first thing I would ask of [central] government colleagues would be to start off the conversation with local authority leaders, management teams, as well as political leaders about how urgent this is, and how we all need to pull together and do something because this is really scary."
Speaking about A&E pressures in her own organisation, Newcastle Hospitals NHS Trust chief exec Dame Jackie Daniel said: "It’s been another incredibly pressured week across the trust and I know how hard everyone is working to support our patients. Although we continue to face significant challenges, we are making strong progress.
"Our urgent and emergency care services and other specialist services all continue to see significantly higher levels of activity – with our attendances in the emergency department for example, being 7% above the pre-pandemic level (with type 1 attendances – the poorliest patients most likely to be admitted – at 21.6% higher). We expect it to be a busy weekend for our emergency pathways."
She said she assured patients and staff that senior managers were "all focussed on relieving the pressures we face through whatever means we can". She said this involved raising the issues with NHS bosses and Government decision-makers around the country. Dame Jackie has also just become chair of the NHS Confederation organisation.
Danielle Jefferies, health analyst at The King’s Fund, said: “A&E departments remain full of patients in need of urgent care, and separate data shows a similar story in general practice and social care.”
NHS England medical director Prof Stephen Powis said: "Nobody should be under any illusion about how tough a job NHS staff have on their hands, balancing competing priorities and maintaining high quality patient care.
"Despite pressure on various fronts and the busiest winter ever for the NHS, long waits fell as staff continue to tackle two-year waits by July thanks to the innovative approaches to care they are now adopting – from same day hip replacements to dedicated mobile hubs for operations.
"If you need help, especially over the often busy bank holiday weekend, please do come forward for the care you need through NHS 111 online and if it’s an emergency, dial 999 or go to your nearest A&E."
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