North East hospital trusts are struggling to discharge patients due to staffing pressures in both the NHS and in care homes.
On January 23, NHS data shows there were 373 patients across five North East hospital trusts who are classed as "medically fit" but are not able to be discharged. Usually this is due to lack of community care provision.
NHS executives in South Tyneside and Sunderland, Gateshead and at the Northumbria Healthcare NHS Trust have spoken of how staff absence and Covid-19 absence in the care sector has led to "delayed discharges" - and a knock-on impact on hospital activity more widely.
Go here for the latest coronavirus updates and breaking Covid-19 news
This is because, as the hospital figures explain, being unable to free up in-patient beds in wards means "patient flow" through the hospital is affected.
Speaking at a meeting of the Gateshead Health NHS Trust's board - which runs the QE Hospital in Gateshead - chief executive Yvonne Ormston said: "We have been really impacted by the fact that the care home and domiciliary care providers have also had staffing pressures and outbreak management issues. We know there were many homes closed to admissions and home care providers were not able to provide us with care.
"Many patients are physically ready to be discharged but the community support has been compromised by these staffing pressures."
The issue is a national one - across England on January 23, almost 13,000 patients were medically-fit to leave hospital but unable to be discharged.
Throughout the winter, the issue has been identified as particularly acute at the South Tyneside and Sunderland NHS Trust - where the central NHS Emergency Care Improvement Support Team (ECIST)- has been working with medics to tackle the issue.
Also speaking this week, that trust's chief exec Ken Bremner said: "We are still suffering with 'medically-optimised patients' - delayed discharges. We still have over 100 patients in the organisation who are medically optimised. Staffing is the biggest issue, we have been grappling with it for some time."
ECIST have observed hospital processes to see what can be done to improve matters and provided feedback to the Trust. Mr Bremner said: "There was nothing in this feedback that we weren't either aware or dealing with already." He told the Trust's board that recommendations focused on making terminology clearer, and added hospital bosses were again reviewing procedures around "patient pathways".
He added the report showed the Trust had "fundamentally the right processes" in place, adding: "But maybe there's a little bit of tweaking here and there to improve the pathways". He said he was pleased with the feedback.
Broken down by hospital trust, there were - as of January 23 - 124 medically fit patients who remained on wards at South Tyneside and Sunderland, 88 at the QE in Gateshead and 85 at Northumbria Healthcare's hospitals across Northumberland and North Tyneside.
The issue is less pronounced at the RVI and Freeman in Newcastle - where 47 medically-fit patients remained in hospital - and at the County Durham and Darlington NHS Trust, where the figure was 29.
The Northumbria Healthcare NHS Trust is also reflecting on the issue, with its chief executive Sir James Mackey telling its board: "It's been a pretty difficult couple of months with with the Omicron wave in general. The main issue in all of our minds has been the impact on staff and absence, not just here but also in the broader healthcare system and the impact that that's had on discharges as well."
The Trust's medical director Dr Jeremy Rushmer added: "The flow that we're able to achieve through ED [accident and emergency] at NSECH is absolutely dependent on maintaining a large number of discharges on a daily basis.
"There has been an impact on ambulance handovers - which we're currently having a big focus on - and there have also been the same staffing problems that we've had in our wards noticeable in care homes."
To help support hospital discharges, NHS England has encouraged the establishment of "virtual wards" whereby - specifically for Covid-19 cases but across other services too - advanced patient monitoring technology is used to allow patients to return home while still being observed by medics.
