PEH could face tough winter with beds issue

Many patients are currently in hospital who do not need to be there, as patients cannot be moved to residential or nursing homes due no spaces being available.

Director of operations Dermot Mullin said: ‘A lack of capacity in the care home sector has a knock-on impact on both hospital and community care services capacity.

‘We have a number of individuals across the PEH whose normal discharge and transfer of care to community services, nursing or residential sector has been delayed.

‘This in turn creates a capacity issue to meet the demand for acute care and increases the number of elective surgery postponements which contributes to increased waiting times,’ he said.

So far 27 procedures have been postponed this month.

‘Despite these challenges, we continue to prioritise surgical procedures in consultation with our colleagues at MSG, for example for cancer care,’ said Mr Mullin.

Waiting times for certain procedures have increased as a result of the pandemic, particularly in endoscopies and orthopaedics.

Endoscopies are an aerosol generating procedure that require special precautions during the Covid period to protect staff.

Medical director Peter Rabey said that the number of gastroenterologists was increased from one to two in response to the Review of Medicine in 2017, and he is working with them both to seek to reduce the waiting lists which have grown during the pandemic.

‘Endoscopy for suspected cancer patients has been, and continues to be, prioritised,’ Dr Rabey said.

A lack of critical care beds has an impact on hospital efficiency as many elective procedures can only take place if there is a critical care bed on standby.

Under the hospital modernisation programme, building a new critical care unit has been prioritised and construction is due to start in 2022.

The new unit will have increased capacity from seven to 12 beds.

An adjacent theatre recovery unit will have 10 beds that can swiftly be converted to additional critical care beds to support any future pandemic demands or other emergency situations.

Gary Yarwood, chairman of the Medical Specialist Group, said: ‘The simple fact is that when community care patients occupy medical beds, acute medical patients have to move to surgical beds, and we then lack the inpatient beds for surgical patients.

‘We are maximising our use of day patients and continue to put our priority one patients first, particularly cancer care, but inevitably other inpatient surgical workload is impacted, especially orthopaedic patients needing joint replacements which can’t be done as day cases.

‘We can make inroads into waiting times if we can operate at full capacity but have to maintain a high percentage of activity just to keep demand with new referrals.’

Acute services associate director Elaine Burgess asked that the family of patients made every effort to get them home as soon as they were safe for discharge.

‘We know that some people are anxious about being discharged from hospital where they have 24-hour-a day care and support.

‘We want to embed a home first ethos – prolonged stays in hospital can be unnecessarily detrimental to your health due to sleep deprivation, increased risk of falls or infection among many other things.

'So, it’s not just about protecting bed space, it really is about ensuring you are in the best place. We would never discharge someone if it wasn’t safe to do so,’ she said.