More than 20 hospitals in England have had to declare a black alert this week after becoming so overcrowded that they could no longer guarantee patient safety and provide their full range of normal services.
Unprecedented numbers of patients requiring care has led to at least 23 hospital trusts declaring they cannot cope since Monday, inquiries by the Guardian have established.
Struggling hospitals have been forced to take highly unusual steps in order to manage a surge in demand for care. They include cancelling cancer operations, treating adults in children’s wards and even closing a birthing centre to help cope with a sudden influx of patients who need to be admitted for treatment.
Hospitals are expected to come under even greater strain over the next few days as unusually cold weather sweeps across much of the country, which doctors fear could prompt a spike in serious breathing problems, among other conditions.
University hospitals of Leicester
NHS trust was under so much strain on Tuesday that it declared a “system critical incident” – even higher than a black alert – and had to make patients wait in ambulances before being offloaded into the care of A&E staff.
The Royal Surrey hospital in Guildford, which is used by many of health secretary Jeremy Hunt’s constituents, declared black escalation status on Monday because it had become “extremely challenged” by the sheer number of patients whom it needed to find a bed for. At one point that day it had 27 patients who needed a bed but nowhere to put them.
Lewisham hospital in south London became so full on Monday it had run out of beds and in an email to staff it described the situations as “critical” and “not safe”. The hospital had nowhere to put the next patient brought in as an emergency by ambulance, it added.
Under guidance which NHS England issued to NHS acute trusts last October ahead of this winter, hospitals were told to declare what is called a black alert when they have become “unable to deliver comprehensive care [and] there is increased potential for patient care and safety to be compromised”.
The NHS document outlining the operational pressures escalation levels (Opel) system explains that Opel 4 means that “decisive action must be taken ... to recover capacity and ensure patient safety” in the face of “rising system pressure”. That black alert is what most of the 23 trusts have gone onto this week, though some have described it as a “serious internal incident” or in similar terms.
The Royal College of Emergency Medicine, which represents A&E doctors, warned that the
already chaotic situation in the NHS could get even worse as the winter weather worsens and that the A&E system is at risk of breaking.
“Emergency departments are overflowing with patients, internal major incidents are being declared around the country and staff in emergency departments are struggling to cope with the immense demand being placed on their services,” said Dr Taj Hassan, president of the Royal College of Emergency medicine.
“These crowded environments are stretching the clinical workforce to their limits and, more importantly, at times are unsafe for patients.”
He urged ministers and NHS leaders to draw up an urgent action plan to rescue A&E care to avoid the quality of care patients receive starting to deteriorate. “Without dedicated funding and planning, both patients and staff will increasingly suffer”, he added. However, it is understood that reports of a package of emergency funding for A&E units are wide of the mark and that the Department of
Health will not be producing any more money, despite mounting problems.
On Tuesday the Royal United hospital in Bath closed its Paulton Birth Centre for two weeks, which is usually used by women having a low-risk pregnancy who want a natural birth, and began using it to house medical patients instead.
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