This week, performance against the winter sitreps sees many similarities to previous weeks, as extremely high demand is met with broadly sound operational performance. Bed occupancy is now at the highest level during the season so far, and with episodes of norovirus increasing in the past week, trusts will be bracing themselves for a challenging end to the official winter reporting period.
Key indicators in week 9 include:
- Bed occupancy increased by 0.3% this week to 94.9%, the highest this winter so far and approaching the peak seen last winter of 95.2%.
- Escalation beds increased by 7% to 3,883, also the highest of the winter so far, but with 800 fewer than the highest number open at any point last winter.
- Total beds open increased slightly by 0.6% to 98,129, again a new high for this winter but 0.4% lower than the same point last year.
- Length of stay is slightly higher than last week, but still considerably lower than the same point last year. The number of patients staying longer than 7 days rose by 0.5% this week to 42,625, but this is 6.6% fewer than the same week last year. Those staying longer than 21 days increased by 0.6% this week, but remains 12.8% lower than last year.
- Beds closed due to diarrhoea and vomiting/norovirus-like symptoms increased by 34%, reaching a new high for this winter, 11% higher than the same week last year. Demonstrating the variability of this measure, it remains 37% lower than its highest point during winter last year.
- There were only 13 A&E diverts this week, down by almost half from 25 last week.
- The number of ambulance arrivals decreased by 0.5% this week to 97,620. Compared to the same time last year, the number of arrivals is 4.5% higher (600 more arrivals per day).
- Ambulance handover delays were very similar to last week. The proportion of arrivals waiting more than 30 minutes was 12.2%, the same as last week, and the proportion waiting more than 60 minutes was 2.7%, 0.1% higher than last week.
With episodes of norovirus increasing in the past week, trusts will be bracing themselves for a challenging end to the official winter reporting period.
tweet this
The recent trend of acute bed occupancy increasing incrementally has continued this week. Bed occupancy now sits at just under 95%, a level unseen this winter and comparable to its peak last winter. In the past week, 44 trusts (out of 134) with an A&E department were running at 99% bed occupancy or higher at some point. Trusts are responding to increased demand by opening more escalation beds, and while the total open this week also reached a new high for 2018/19, this remains considerably lower than the highest number open in last winter.
Worryingly, the number of beds closed with D&V and norovirus rose dramatically, particularly over the last three days of week. 50 trusts are now affected, with the north region closing more than double the number of beds of any other region, and it would be extremely disappointing for a high number of beds to be unavailable in the coming weeks as a result of further outbreaks.
Length of stay indicators reflect real improvement compared to last year. The number of patients staying over seven days and over 21 days both increased slightly this week, but 3,000 fewer patients stayed over 7 days and 2,300 fewer patients stayed over 21 days than at the same point last year. We have heard from many trusts about local efforts to efficiently discharge and support patients in their homes, and this week we showcase the work of the neighbourhood nursing service in Barnsley, part of the South West Yorkshire Partnership NHS Foundation Trust. While the local acute trust currently has a bed occupancy rate above the national average, the work of this team has contributed to a reduction of over 25% in the number of patients remaining in hospital longer than 21 days, compared to a year ago.
Worryingly, the number of beds closed with D&V and norovirus rose dramatically, particularly over the last three days of week.
The number of ambulance arrivals has been high all winter, and this week was no exception. On average, just under 14,000 patients arrived per day, 4.5% higher than a year ago. The proportion of arrivals with delayed handovers is very similar to last year, meaning the total number of people handed over within reported time limits is considerably higher than the previous winter. Ambulance trusts continue to seek efficient methods to care for patients around the point of handover while meeting these targets, and the preservation of handover performance while activity has skyrocketed points to the success of these efforts.
A number of measures this week indicate that trusts have just experienced the busiest week of winter so far. It is to the credit of trusts and their staff that operational performance is holding up as well as it is. Challenging conditions may still be around the corner, and with demand reaching peak levels the system remains braced for high levels of activity as we enter the final month of the winter reporting period.
For a more detailed breakdown of this week’s winter sitrep data please see our summary dashboard.
Barnsley’s neighbourhood nursing service
Barnsley’s neighbourhood nursing service is essential in preventing unnecessary admission to hospital – a service that is vital in the colder winter months when seasonal pressures on acute hospitals are high and travel becomes difficult.
147 clinical staff work within the neighbourhood nursing service, planning personalised care with patients and helping them to increase their awareness in order to manage their condition. Neighbourhood nurses use their clinical skill and judgement, are flexible, and work with partners to get the best outcomes for the patient.
Here’s the neighbourhood nursing service in a nutshell...
NHS staff pulling out all the stops for busiest week of this winter
Responding to the latest weekly winter performance data from NHS England, NHS Providers director of policy and strategy, Miriam Deakin, said:
"The return of cold weather and rising cases of norovirus have helped to create the busiest week so far of this winter for health and care services.
"The number of beds in use across the system remains very high at just under 95% - approaching the peak of last winter. The number of patients arriving by ambulance, although slightly down on last week, is still exceptionally high. With 34% more beds closed because of norovirus, the situation on the ground is extremely busy.
"Despite this, NHS staff are pulling out all the stops to deliver for their patients. It is positive to see that their efforts to get people home quicker from hospital are paying off. This is good for patients and supports trusts to manage winter demand effectively."