‘Winter is going to be a humanitarian crisis unless urgent action is taken’, fear senior NHS sources. The grave concerns come as the number of patients who are medically fit to go home, but cannot be discharged from hospital, are ‘higher than ever’ in one Greater Manchester hospital.
Patients have been facing months of severe delays to their discharge from hospital, primarily because of chronic shortages of staff and space in social care. The volume of patients medically well enough to go home but ‘stuck’ in hospital is now ‘more than in any other year - not by a few but double, triple what we would expect’, one source has told the Manchester Evening News .
Medics from across the NHS have sounded alarm bells that overcrowded A&Es, long ambulance wait times, and a serious scarcity of ward beds have plagued the summer months. If the NHS is already in a ‘mid-winter position in August’ - the time the NHS is supposed to recover - ‘it does not bode well for winter’, warns another doctor.
The number of patients facing delays to their discharge, including those medically well enough to go home or into a care home, has been hovering at around 1,000 in Greater Manchester for months - around one-fifth of all of the region’s hospital beds.
However, throughout last month, the numbers approached as high as 1,500 a number of times across Greater Manchester hospitals. As of July 31, the most recent figures published by the NHS, some 1,277 patients ‘no longer met the criteria to reside’ in hospital. The figure dipped to 972 by the end of the evening as some patients are discharged after 5pm.
On June 30, the number stood at 1,480, falling to 1,003 by the end of the day. On the final day of May, there were 1,294 patients who no longer met the criteria to stay in hospital, dropping to 777 by midnight.
On the final day of April, the month the NHS began publishing bed discharge data this year, 1,458 patients had no reason to reside. The figure was 974 by the end of the night.
“As a consequence, sicker medical patients are having to be cared for in other parts of the hospital,” one senior health source told the M.E.N, as wards are crowded with patients who could go home.
“The issue is in the community - access to social care, nursing and care home capacity, and the demand on the hospital and staff as a result of a pandemic that stretches into its third year.”
Medics have previously told the M.E.N. that the sheer lack of beds leads to patients being left in parts of the hospital they should not be, such as on trolleys in A&E, on corridors, or in the back of ambulances - for hours at a time. This is leaving patients at risk of dangerous deterioration as they are not being treated in a 'safe place', doctors have warned.
More patients at Manchester's hospitals faced long waits for A&E and ambulance services in July than any other month on record, new figures show. Last month in Greater Manchester, almost 1,751 people endured more than 12 hours of waiting in A&E for a bed on a ward, after medics decided they were unwell enough to be admitted to hospital.
That figure comes as a stark difference from just 158 patients facing this wait in July 2021, according to data published by NHS England. It marks the highest number of people facing long waits for a ward bed since monthly records began in June 2015.
Greater Manchester NHS bosses say high levels of patients in hospital with Covid-19 are also adding to pressures. They are urging people to use the right service for the nature of their illness.
Dr Chris Brookes and Professor Jane Eddleston, joint interim Greater Manchester medical executive leads for acute care, told the Manchester Evening News : “The statistics show our hospitals continue to experience significantly high levels of patients in A&E and emergency ambulance call outs, as well as high levels of demand for other services across Greater Manchester, such as community care.
“This is coupled with high levels of Covid-19 bed occupancy and the ongoing challenge of discharging patients who are medically fit enough into community and social care settings, though we are making progress in that regard. We are working hard to address these issues across the city region as well as improving ambulance handover times to the care of A&E staff.
“It remains as vital as ever that people come forward for care when its needed though we would ask that if your need is urgent but isn’t an emergency, please use NHS 111, either online or over the phone. Their trained advisors will be able to help and direct you to the best place to get treatment. Pharmacies are also a good source of guidance and help for non-emergency situations.”
As the cost-of-living crisis rages on, health will only become worse in the near future and impact deprived areas disproportionately, continues the source. Residents facing fuel and fuel poverty will be the first to need help, and there will be yet more demand on the NHS.
“The consequences of a hospital being full and unable to discharge patients is an emergency department which is overcrowded,” the source said.
“If the emergency department is overcrowded, then the ambulances can’t offload patients. This winter is going to be a humanitarian crisis unless urgent action is taken.”
NHS bosses have made an 'unprecedented' appeal to the Government to take action on rising energy prices as the UK faces a 'public health emergency'. The NHS Confederation sent a letter to ministers on Friday, warning that surging costs mean people will have to choose between skipping meals to heat their homes or living in cold and damp conditions this winter.
Health leaders said they are concerned that widespread fuel poverty will increase the high number of annual deaths associated with cold homes – estimated at 10,000 – and add pressure to an already overwhelmed health service.
NHS Confederation chief executive Matthew Taylor said: “The country is facing a humanitarian crisis. Many people could face the awful choice between skipping meals to heat their homes and having to live in in cold, damp and very unpleasant conditions.
“This in turn could lead to outbreaks of illness and sickness around the country and widen health inequalities, worsen children’s life chances, and leave an indelible scar on local communities.”
Mr Taylor said these outbreaks of illness will strike 'just as the NHS is likely to experience the most difficult winter on record'.
“NHS leaders have made this unprecedented intervention as they know that fuel poverty will inevitably lead to significant extra demand on what are already very fragile services,” he added.
“Health leaders are clear that, unless urgent action is taken by the Government, this will cause a public health emergency.”
Steve Dixon, chief delivery officer at NHS Greater Manchester Integrated Care, said: “Discharging patients from hospital back to their home or into the community with appropriate support, as soon as it is clinically appropriate to do so, is our number one priority. Each patient’s requirement to be in hospital is kept under regular review.
“Working as a partnership across Greater Manchester, we are making progress in ensuring people do not need to be in hospital longer than absolutely necessary. We will continue to provide the best possible care we can to our patients.”
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