Patients in Bristol and Weston-super-Mare who no longer need to be in hospital are taking up four wards' worth of space, according to health bosses.
While the number of patients admitted to hospital with Covid-19 has fallen, local hospitals are still struggling to catch up with a backlog of pressures. Several problems are facing the University Hospitals Bristol and Weston NHS Trust, which runs sites including the Bristol Royal Infirmary and Weston General Hospital.
These include long ambulance handover times, patients stuck in hospital who don’t need to be there known as 'bed blockers', and recruiting and retaining staff. Hundreds of nurses left the trust last year, and emergency departments sometimes see “unacceptable delays”, according to the trust's chief executive.
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All of these challenges have resulted in patients waiting longer to be treated, and as of last April, there were 349 patients who had been waiting more than two years for treatment. Health bosses described the problems facing the trust (UHBW), during a board meeting on May 27.
Dr Mark Smith, deputy chief executive of UHBW trust, said an increasing number of patients didn’t need to be in hospital any more, but faced long delays in getting discharged. These patients with ‘no criteria to reside’ in hospital are impacting ambulance handover times, emergency departments, and elective surgery, as they take up four wards' worth of beds, he said.
He said: “The trust is running very hot even though it’s summer. A couple of months ago the no criteria to reside [figure] was in the 140s, but at the beginning of this week it was 221, which is equivalent to four-plus wards of activity. Performance in the emergency department remains suppressed and reflects the congestion and lack of flow in the hospital. Over the last two years we’ve seen waiting lists virtually double.”
Many patients who no longer need to be in hospital face the risk of deteriorating physically due to staying sedentary and in bed for so long, according to Deirdre Fowler, chief nurse, potentially meaning more people are falling over. She said: “These patients are at risk in our organisation, and one of the main risks they face is deconditioning. And we can see the parallel in deconditioning and our increase in falls.”
500 nurses left last year
Another huge challenge faced by local hospitals is keeping staff, with record numbers quitting and leaving the trust. Emma Wood, director of people, said bosses were looking overseas for potential new recruits, and drawing up plans to keep staff in the job for longer.
She said: “Our turnover continues to be the highest that UHBW has ever experienced with a vacancy factor particularly large within the division of medicine. International recruitment is ongoing. We lost around 500 nurses last year.”
Emergency departments are facing “unacceptable delays”, according to Eugine Yafele, chief executive at the trust, and ambulances waiting outside hospitals mean fewer people can be looked after in the community.
He said during the meeting: “Our organisation and partners across the system are really struggling with flow, which is people accessing, moving through services and being discharged in a timely manner. We see this particularly in our emergency department where we still have unacceptable delays in terms of ambulance handovers. This has an impact on ambulance services and people’s ability to receive care in the community.”
