NHS England advise hospitals to postpone non-urgent care
NHS England has advised hospitals to defer non-urgent, elective operations and procedures until next month to allow the health service to deal with high pressures over the winter period.
According to the National Emergency Pressures Panel (NEPP), the NHS has been under sustained pressure over the Christmas period with high levels of respiratory illness, high bed occupancy levels, and early indications of increasing flu prevalence.
To free up capacity for the sickest patients and time for non-elective care, day-case procedures and routine outpatient appointments should also be delayed, while clinical commissioning groups should temporarily suspend sanctions for mixed sex accommodation breaches.
Further recommendations include the installation of consultant triage at the entrance so patients are seen by a senior decision maker on arrival at the emergency department, the staffing of additional inpatient beds, and twice daily patient reviews to facilitate discharges at the earliest opportunity.
The advice came as the results of the latest data from the Royal College of Emergency Medicine’s Winter Flow project showing a continued decline in performance on the 85% four-hour A&E standard, which stood at 78.14% for the third week of December, down from 81.52% the previous week.
“Given the clear link between four-hour standard performance and clinical outcomes for patients, this has to be a concern,” the College stressed. “Nearly half of our contributors are now declaring performance of below 80% and a significant number of Trusts in England are now declaring performance of between 50% and 69%.”
Delayed transfers of care and cancelled elective operations were on the rise week-on-week, signalling further pressures on the system.
“With all but five hospitals in England running at above the recommended safe bed occupancy level of 85% and almost a fifth running at 99%, the system has little to no capacity to handle a major flu outbreak or spike in demand caused by a cold snap over the coming weeks,” Dr Chaand Nagpaul, BMA council chair, recently warned.
Professor Sir Bruce Keogh, who chairs NEPP, said the high levels of pressure seen over the Christmas period are indeed expected to continue. “The NHS needs to take further action to increase capacity and minimise disruptive last minute cancellations. That is why we are making these further recommendations.”