NHS winter pressures: Thousands of pre-planned operations and appointments delayed

NHS England urges deferral of non-urgent inpatient elective care to free up hospital staff and beds be extended until 31 January 
Trolly waits

NHS England urges deferral of non-urgent inpatient elective care to free up hospital staff and beds be extended until 31 January 

  • NHS had entered winter period ‘in a way that we’ve never prepared before’ 
  • Up to 55,000 deferred operations in England
  • A number of hospital trusts declare Operational Pressures Escalation Level 4

Tens of thousands of pre-planned operations and routine outpatient appointments in England will be delayed until the end of the month due to severe winter pressures.

NHS leaders have defended the decision insisting the health service had entered the winter period ‘in a way that we've never prepared before’.

Drastic steps to free up beds and staff

In a drastic step to try to free up hospital staff and beds, NHS England also last night said the deferral of non-urgent inpatient elective care - such as hip replacements - should be extended until 31 January.

Officials have estimated that this could lead to up to 55,000 deferred operations, although cancer operations and time-critical procedures should go ahead as planned, NHS England said.

The move comes after leading medics warned that every emergency department in the country is struggling to cope with winter pressures.

Some hospitals have declared themselves at the most severe pressure level while doctors warned that scores are operating at almost full capacity.

Ambulance services under severe pressure

Meanwhile, a number of ambulance services are also under severe pressure, with two even resorting to taxis to ferry patients to hospital.

NHS England hopes the measures will free up senior hospital doctors to triage more patients in emergency departments, be available for phone advice for GPs and ensure that patients in hospitals are reviewed twice each day to help timely discharges.

It also announced that sanctions for mixed sex accommodation breaches should be temporarily lifted.

Normally, under NHS rules, men and women are supposed to be treated on different wards and breaches can lead to fines.

Meeting of National Emergency Pressures Panel

NHS England announced the measures following a meeting of its National Emergency Pressures Panel.

In a statement, it said that the panel discussed ’sustained pressure over the Christmas period’ with high levels of respiratory illness, high bed occupancy levels, signs of increased flu activity and a rise in the number of severe cases attending emergency departments.

NHS England director for acute care Keith Willett today acknowledged that the delay to patient care was ‘not ideal’, but said the NHS was ‘better prepared’ and clear recommendations were being implemented to deal with pressures.

He told BBC Radio 4's Today programme: ‘A crisis is when you haven't got in place mitigations and you haven't got a plan to deal with it.

‘Increased potential for patient care and safety to be compromised’

‘We've gone into this winter in a way that we've never prepared before. We went into the winter before Christmas having cancelled fewer elective operations than we had previously, discharges from hospital were at a lower level than they had been previously, so we were better prepared.’

A number of hospital trusts have declared Operational Pressures Escalation Level 4 (OPEL4) which means: ‘Pressure in the local health and social care system continues to escalate leaving organisations unable to deliver comprehensive care. There is increased potential for patient care and safety to be compromised.'

Among organisations contacted by the Press Association news service, Darent Valley Hospital emergency department in Kent, Royal Cornwall Hospital and University Hospitals Of Leicester NHS Trust and Torbay and South Devon NHS Foundation Trust have all said they have declared OPEL4 in the last week.

Despite winter pressures, patients booked in for outpatient procedures are urged to continue to attend their appointments at The Queen Elizabeth Hospital King’s Lynn in Norfolk.

Concerned phone calls from patients

Leaders at the hospital are expecting a wave of phone calls from patients who are concerned about their appointment following recent national media coverage about the NHS winter plans.

Chief executive Jon Green said: ‘While we have cancelled some operations, and despite high levels of attendances at A&E, we would like to reassure the public that our outpatients appointments are running.

‘So we would ask all patients to continue to attend their appointments as normal unless we contact them directly. However, we continually review the situation.’

‘Worse than the equivalent period last year’

Meanwhile, Somerset Clinical Commissioning Group said the health system in the whole county has declared OPEL4.

As an A&E consultant @UHNM_NHS I personally apologise to the people of stoke for the 3rd world conditions of the dept due to #overcrowding

— Dr Richard Fawcett (@docfawcett) January 2, 2018

Emergency medicine consultant Adrian Boyle, who is the Royal College of Emergency Medicine chair for quality, said: ‘Every type 1 emergency department that I know of is under serious and sustained pressure.

‘It feels worse than the equivalent period last year.’

Health secretary apology

Health secretary Jeremy Hunt today apologised to patients who have had operations delayed, telling Sky News: ‘It is absolutely not what I want’.

But he said: ‘We recognise that it is better, if you are unfortunately going to have to cancel or postpone some operations, to do it in a planned way, and that's why this year this independent panel has decided to take this decision and that, I think, in the end, is better for people.’

Meanwhile, prime minister Theresa May rejected claims that the NHS was in crisis, saying the service had more funding, beds and had also reduced delayed discharges of older people to free up more beds. She said NHS staff were doing a ‘fantastic job’ and operations would be rearranged as soon as possible.

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