Operations postponed as Oxfordshire sees a rise in sick patients this winter

A rise in 'sicker' patients is forcing hospital chiefs to cut operating lists for those needing non-urgent surgery.

Monday, 3rd February 2020, 3:37 pm
Updated Monday, 3rd February 2020, 3:37 pm
The John Radcliffe Hospital, Oxford
The John Radcliffe Hospital, Oxford

Some patients are not being told about their procedure cancellation until the day of the op - and some have only found out on arrival.

One Banbury patient, who had had his operation put off twice in two weeks, said: "I had my operation scheduled for a 10:30am admission at the JR, Oxford but when l got there l was told they had tried to phone me without success while l was en route to inform me the op had been postponed for two weeks for non-availability of beds.

"Two weeks later, once again, l had my operation postponed. This time l got a call on the way there. Again a lack of beds was cited. My condition is not urgent supposedly but others will have been turned away with life threatening conditions like heart surgery.

"It is inhuman to patients and what is it costing the hospital in wasted payments to the consultants, anaesthetists and theatre staff? Surely that money could be spent on opening beds at this time of year so operations can still go ahead" he said.

One woman on social media said her operation had been postponed until April or May at the earliest rather than in the three weeks originally arranged. Another had been prepared ready for surgery when her operation was cancelled because of a lack of intensive care beds. A third said her child's operation had been postponed because there were insufficient staff to meet safe patient-nurse ratios for the empty beds.

Many patients spoke in glowing terms about successful operations, at the time planned, and praised the excellent care given by hospital staff.

An Oxford University Hospitals Trust (OUH) spokesman said 44 non-urgent operations had been postponed in November but figures for December and January - the time of the worst 'winter pressures' when care is earmarked to emergencies - were still being validated.

"It is always regrettable if planned operations have to be postponed and these decisions are never taken lightly by our clinicians. They are based on the need to maintain high quality and safe services for all patients. But unfortunately, there are times when it is necessary in order to prioritise the care of the sickest patients. We would like to apologise for the distress and inconvenience caused to any patient whose procedure has been postponed.

"Where possible, we have opened up additional beds to support winter pressures. This is paired with a number of staffing incentives to support this," she said.

"We monitor staffing levels on a daily basis to ensure we can provide safe care to our patients. This winter, we have several plans in place to support the additional demands on our hospitals, however we have seen an increase in sicker patients which means that many more patients have required admission.

"We continue to work hard across the health and social care system to help people leave hospital safely and quickly and where appropriate, receive treatment closer to home, ensuring our staff can care for people who really need to be in hospital.

"A theatre improvement programme is underway, which aims to reduce the number of patients having on-the-day cancellations. It will also help us compile more helpful data to plan and target improvements in this area.

"We are looking to shortly open up to 22 more beds in the adult Intensive Care Unit at the John Radcliffe Hospital with an aim of increasing this to 24 beds by April. We’re also setting up a group to discuss high dependency unit space at all of our hospitals and how we can improve this."

The trust would not give the Banbury Guardian an estimate of the cost of cancelling operating lists. The trust spokesman said the OUH was using as many agency and bank staff as it could safely to support the permanent workforce.

"When there are postponements, all staff involved are deployed to other areas across the Trust where their support is most needed," she said.

Dr Peter Fisher of Keep the Horton General said: "The repeated postponements can be very inconvenient and distressing for patients, particularly if they have made the journey to Oxford,which may have involved arranging time off work for themselves or those transporting them, organising child care etc. It is also a waste of valuable and expensive hospital resources, with the medical and other theatre staff almost certainly having no alternative occupation.

"Winter pressures are a fact of life which it should be possible to plan for. Closure of beds has gone too far, as Simon Stevens (head of NHS England) has acknowledged, leaving no slack in the quieter times so that crisis point is always only just around the corner. No doubt the funding deficit is a major part of the problem but staff recruitment and retention are also contributory factors. The whole problem needs to be addressed as a matter of urgency and the new government held to its manifesto promises."

OUH and other health and care organisations including Oxfordshire Clinical Commissioning Group, Oxford Health, South Central Ambulance Service and Oxfordshire County Council work together to forward plan for the challenges of winter.

"The Oxfordshire Winter Plan is a joint plan in recognition of the fact that ‘winter pressures’ don’t just affect the Horton General and other acute hospitals. Availability of community beds, social care support, community pharmacists, minor injuries units and helping people choose the right service are all part of this picture" said the OUH spokesman.