Hundreds of patients at Derby's A&E departments waiting hours on Trolleys and in Ambulances
In January this year, 850 patients were on trolleys for more than 12 hours at the University Hospitals of Derby and Burton.
Hundreds of patients waited on trolleys for more than 12 hours and hundreds of ambulances spent hours queuing outside Derby and Burton’s hospitals in the nation’s busiest ever month in A&E.
These are core symptoms of an NHS system under continued intense pressure and strain which have never fully calmed since the pandemic.
Hospital officials say the country experienced its busiest ever month in January with more than 14,500 patients visiting its two A&Es in Burton and Derby and 5,000 ambulance arrivals at Royal Derby and Queen’s.
Before the pandemic it was obscenely rare for a hospital to have one patient stranded on a “trolley” for more than 12 hours and such an event would have triggered an extensive deep dive into what went wrong.
In January this year, new figures detail, a total of 850 patients were on trolleys for more than 12 hours at the University Hospitals of Derby and Burton.
The trust, which operates Royal Derby Hospital and Queens’ Hospital in Burton, has accumulated 4,357 total 12-hour trolley breaches in the past year to date.
It maintains a target to have zero 12-hour breaches which is its same target from before the pandemic, but it has now not come anywhere close to zero for four years.
Meanwhile, new figures also detail that in January the trust encountered 768 instances in which ambulances were left waiting more than 30 minutes outside A&E departments and 613 incidents in which ambulances were left waiting more than an hour.
The trust has had 6,535 30-minute breaches and 3,532 hour breaches over the past year, representing many shifts in which ambulance staff have not been available to perform potentially lifesaving duties.
These situations mean ambulances cannot leave to attend to other emergencies but do not mean patients have been left waiting in the back of emergency vehicles.
At one stage the trust declared that these incidents would also be classed as “never events” with associated deep dive investigation for each occurrence.
Prior to the pandemic, these incidents were also highly unusual but are a cause of system-wide pressure with the issue directly related to delays in discharging patients from hospital into either their own homes or a care home – due to shortages of places.
This has led to private organisations being called on – and paid – to provide spaces to make up for the shortfall in public provision.
A further associated problem connected to both the 12-hour trolley delays, ambulance delays and discharge delays is the pressure being faced at the emergency departments – the “front door” of the NHS.
January’s record level of pressure led to the average patient spending more than nine and a half hours in A&E before being admitted and more than three and a half hours before being sent home.
The hospital trust says more than 30 per cent of patients – three in 10 – were not seen within four hours in January, which is the NHS target, with 69.5 per cent of patients seen within this time.
This placed the hospital trust eighth out of 21 organisations in the Midlands (average 68.9 per cent) and 49th out of 123 nationally (average 70.3 per cent).
The trust says this has improved to 72 per cent to date, behind the national target of 76 per cent.
UHDB says it plans to expand its urgent treatment centre hours at Royal Derby Hospital and to develop an urgent treatment centre “offer” at Queen’s Hospital in Burton.
Andrew Hall, interim executive chief operating officer, said: “Despite January being the busiest month ever nationally for the number of people attending A&E, which included more than 14,500 people in our own hospitals, thanks to the hard work of staff we saw more patients within four-hours compared to December and we have continued to improve this month-on-month since.
“It does remain exceptionally busy and we are trialling a number of new initiatives to try and improve the experience our patients have with us and see people more quickly – including looking to extend our urgent treatment centre hours, piloting having a GP at the emergency department front door to help direct patients to the right service, and seeing more patients through our ‘same day’ service where we can give people the care they need and discharge them home the same day.
“Our teams are committed to doing all they can to see people quickly and will always prioritise patients based on their clinical need.
“Our communities can help us by making sure they access the right NHS service for their needs, like using urgent treatment centres or minor injury units where they will be seen quicker than at a busy A&E department, or using NHS 111 on the phone or online for advice on where best to go for help.”
The hospital trust says it knows it has “further to go” on ambulance handover times but claims it is positioned well regionally.
It says it is working closely with social care organisations to get patients out of hospital and on to their next place of care “as early as possible, which is best for their recovery and for the NHS”.
The trust added that “hospitals have tried and tested plans for managing demand and winter pressures” and that “it is a testament to our staff that we have improved our emergency department performance at a time of intense pressure, whist also maintaining our elective programme to ensure we reduce the number of patients waiting for operations and procedures.”