Beds taken from Horton dialysis ward to help A&E cope with ‘black alert’

The Horton A&E has experienced unprecedented pressure
The Horton A&E has experienced unprecedented pressure

Six beds from the Horton’s dialysis ward have been temporarily taken over by A&E to help it cope with the hospital on the highest possible alert.

The move has been described as ‘necessary’ for the emergency department to manage but it means dialysis patients have to go to the Churchill Hospital in Oxford.

Keith Strangwood at The Horton General Hospital, Maternity Unit, in Banbury. NNL-160706-143901009

Keith Strangwood at The Horton General Hospital, Maternity Unit, in Banbury. NNL-160706-143901009

Oxford University Hospital NHS Foundation Trust, the body responsible for the Horton, John Radcliffe and other Oxford hospitals, has been on Operational Pressure Escalation Level 4 (OPEL 4) since Tuesday, the highest alert possible and known as ‘black alert’.

The alert is blamed on seasonal high volumes of attendances at A&E, difficulties in discharging patients who are medically fit to leave hospital – commonly known as ‘bed blocking’, flu and the 100 or so confirmed inpatients since November.

Forty-five medical beds were closed in October, 2016, and campaigners always argued the beds would be needed during the winter.

Keith Strangwood, chairman of Keep the Horton General campaign, said: “They took away 45 medical beds in 2016 – it’s no surprise they now have nowhere to put sick patients.

“But they are still talking about even more beds being closed.

“It’s all a nightmare. Things are getting worse and we did warn that this would happen. They don’t listen.

“Cost-cutting can only be done effectively by reducing staff costs and that inevitably leaves beds as ‘unsafe’ through staffing shortages – so they close them.

“With GPs under strain people are going to go to A&E.

“You can’t tell people not to if they have a problem that’s getting worse.”

Planned operations, excluding cancer and urgent cases, at the John Radcliffe and Churchill hospitals and the Nuffield Orthopaedic Centre have been postponed until Friday, January 26, to help the emergency departments cope.

Where clinically safe to do so, some of these procedures may be offered on a day case basis and therefore may still be able to go ahead.

Outpatient appointments, day case operations, diagnostic tests, cancer care and emergency treatment are not affected and will continue as normal.

Trust clinical services director Paul Brennan told the Banbury Guardian on Tuesday: “We are experiencing seasonal high volumes of attendances at our emergency departments.

He added: “People should think carefully about where they can most appropriately be treated and only attend a hospital emergency department if that is the right place to be.”

OPEL 4 is declared when there is ‘increased potential for patient care and safety to be compromised’ and ‘external extensive support and intervention is required’, according to NHS England.

In a letter seen by the Banbury Guardian, Mr Brennan said 23 beds at the Nuffield Orthopaedic Centre would open today to act as a ‘medically fit for discharge unit’ to release pressure on the acute medical beds at the JR.

“Elective adult inpatient operations, excluding cancer and urgent cases, at the JR and Churchill hospitals are to be postponed from today until January 26,” his letter says.

“In addition a range of non-urgent primary inpatient procedures at the Nuffield Orthopaedic Centre are to be postponed until January 26. I expect approximately 105 to 115 operations a week will be postponed (50 at the JR, 40-45 at the Nuffield and 15-20 at the Churchill).

“Importantly, we will continue to treat urgent and cancer elective inpatients. Day case activity, outpatients and diagnostic procedures will continue as planned across all four hospitals.Inpatient and day case children’s surgery will continue..

“We are sourcing an additional 19 beds from the nursing home sector. Overall this will increase capacity by 64 beds and colleagues at Oxford Health have opened an additional 12 community hospital beds.

“Whilst these actions are necessary to support our emergency department and emergency assessment units at the JR and HGH, we recognise these are short term measures.

“The health and social care system must remain focused on developing and growing home based services given over 150 patients in our acute and community hospitals could be more appropriately cared for at home.”

Hospitals across the country have been told by NHS England to delay pre-planned operations and routine outpatient appointments until the end of the month to free up beds.

National Emergency Pressures Panel chairman Sir Bruce Keogh said on Tuesday: “I want to thank NHS staff who have worked incredibly hard under sustained pressure to take care of patients over the Christmas.

“We expect these pressures to continue and there are early signs of increased flu prevalence.

“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 today.”

People are urged to only attend A&E in a genuine emergency, and there are alternative healthcare services available in the county.