Thousands of patients are staying in hospital for longer than necessary – as Greater Manchester hospitals struggle with ‘extreme overcrowding’ because of a scarcity of beds.
A total of 859 patients in Greater Manchester hospital beds were deemed well enough to go home on December 29. Only 189 were discharged though (22%), meaning that 78% of people deemed well enough to go home were left to take up hospital beds.
Over the last few years, the number of those patients has often topped 1,000 – around one-fifth of all the beds in Greater Manchester.
On Sunday December 29, a total of 16,313 patients across all NHS hospitals in England were deemed well enough to be discharged, according to latest figures published by the health service. Fewer than a third of those (5,135), however, were actually sent home.
That left 11,178 patients (68% of the total) in hospital beds unnecessarily.
At the end of December, the situation was worst at Northern Care Alliance NHS Foundation Trust, which runs Salford Royal Hospital, Fairfield General Hospital, Rochdale Infirmary, and the Royal Oldham Hospital, where none of the 154 patients deemed well enough to be sent home were discharged.
Staff have come forward with stories of ‘extreme overcrowding’, where emergency departments have been filled with as many as 180 people
(Image: Getty Images)
Just three of the 67 well patients (4%) were sent home from Tameside and Glossop Integrated Care NHS Foundation Trust hospital beds. At Bolton NHS Foundation Trust, running the Royal Bolton Hospital, the discharge rate of healthy patients was at just 18%.
At Manchester University NHS Foundation Trust it was 27% – the trust runs the most hospitals in the country, including all the hospitals in Manchester and Trafford.
And at Wrightington, Wigan and Leigh NHS Foundation Trust, which runs the Royal Albert Edward Infirmary, it was 38%, and at Stockport NHS Foundation Trust, operating Stepping Hill Hospital, it was 41%.
‘Beds have been lacking for months, now we’ve got a flood of flu patients coming to hospital’
Senior NHS figures on the frontline have told how – in the days before Christmas and during this weekend’s cold snap – hospitals have been short of beds. It has led to ‘severe overcrowding’ even in some of the region’s biggest A&Es, despite hundreds of patients being medically fit enough to leave hospital.
In the days before Christmas, high-level health sources told the Manchester Evening News of standing room only in the region’s A&Es, waits of more than 36 hours for a bed, frail patients breaking limbs, and elderly people in their 80s and 90s spending hours lying on trolleys in corridors.
Multiple anonymous accounts painted a bleak picture of what that looks like on the frontline. Staff have come forward with stories of ‘extreme overcrowding’, where emergency departments have been filled with as many as 180 people.
“We’re back to corridor medicine,” said one consultant. “There’s such overcrowding for so long it’s hard to say that it’s suddenly got worse, it’s been there all year because of the lack of beds. But there’s now the additional burden of Covid and flu, and everything seems to be falling down.”
Not enough care on offer outside of hospital
While people are coming to A&E in their droves, there are not nearly enough people leaving their hospital beds. It’s an ‘exit block’, say staff, as people who are medically fit enough for discharge are left languishing in desperately-needed beds by an underfunded social care system that has no more capacity.
“There’s a lot of respiratory viruses, a lot of people needing care that they’re not getting elsewhere so they’re coming to the emergency department as a last resort,” explained one consultant working in Greater Manchester right now. “People come to A&E because they’re desperate, it’s really hard to get primary care anyway.
“I don’t want to blame other parts of the NHS but it’s almost impossible to get a same day appointment. It’s not unreasonable that people want to get their health problems sorted. But there’s an exit block.”
This year, the NHS issued a national call to families to help get their ones home and support them after their hospital stays.
NHS England North West’s Medical Director for System Improvement and Professional Standards, Dr Gareth Wallis, has been urging family members to do everything they can to get their loved ones home. He said: “The longer people stay in a hospital bed, the harder they may find it to get up and about as you get better. So, it’s really important that we work with families and patients to get them home when it is safe to do so.”
The shortage of beds comes amid a ‘tidal wave’ of Covid-19, flu, RSV and norovirus piling on the pressure
(Image: Liverpool Echo)
But other doctors say that social care packages needed to facilitate moves back home, like carers visiting periodically throughout the day, can still often not nearly be enough to ensure people stay safe at home. Round-the-clock care is hard to come by and expensive, while care home spaces can be as scant as hospital beds.
Expecting families, untrained in health care, to fill in the gaping holes is neither fair nor safe, say some doctors.
“Families do want to do their best but sometimes it’s unsafe for them to do also,” said one of the consultants the Manchester Evening News spoke to just before Christmas. “Asking someone in their 80s to look after their spouse who is also in their 80s isn’t right.
“You’re asking the public to step in and do a job that should be the state’s. We have a national health and social care provision in this country.
“Families need to be enabled to take their loved ones home by support in the community focused on making sure it’s safe to take them home and that the home is going to be safe.”
The true impact of the ‘quad-demic’ unfolds
The shortage of beds comes amid a ‘tidal wave’ of Covid-19, flu, RSV and norovirus piling on the pressure – dubbed a ‘quad-demic’ by NHS chiefs. The NHS has warned it could be seeing its worst ever winter flu season as cases continue to soar, with Greater Manchester seeing almost three times the number of people in hospital with flu compared to this time last year.
An average of 4,469 patients were in England’s hospitals with flu in the week ending Sunday December 29, according to the latest official figures. That’s five-times as many cases as the same time last year when there were an average of 942 in hospital with flu, and is more than double the average at the same time in 2022 when there were 2,088 flu patients in hospital.
A total of 4,102 people spent Christmas Day in hospital with flu this year, while the number of patients peaked on Sunday when there were 5,074. Greater Manchester is also experiencing far more cases this year.
There were an average of 197.3 patients with flu in the region’s hospital beds in the week ending December 29. That’s up from 150.7 a week earlier and is almost three times as many as the same time last year when there was an average of 69.4. In 2022 however, there were an average of 406.4 patients in hospital with flu over the same seven day period.
Colin Scales, deputy chief executive at NHS Greater Manchester, said: “Demand for NHS services is always higher in January, with a significant increase in illnesses such as flu, respiratory infections, and other winter-related conditions. These pressures are expected and we plan for them to ensure that the NHS is prepared with staff working hard to ensure that patients receive the care they need.
“Across Greater Manchester, the NHS is working with local councils and partners in the community to quickly and safely discharge patients who no longer need to be in hospital, ensuring beds are available for those requiring urgent care. We are also working alongside the North West Ambulance Service to manage delays and speed up patient transfers. All steps are being taken to ensure patients receive the care they need promptly and safely.
“We are committed to providing safe, high-quality care, and our dedicated staff are working hard to support patients during this challenging period. Please follow NHS guidance on where to seek help to ensure we can continue delivering the best care possible to those who need it most. NHS 111 can help by providing expert advice and guidance, directing people to the most appropriate care based on their needs.”