NHS England is advising hospitals to defer non-urgent, elective operations and procedures until next month to help the health service 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.
Also, some reports are suggesting a rise in the severity of illness among patients arriving at A&Es, it noted.
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 front-door 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 move follows the latest data from the Royal College of Emergency Medicine’s Winter Flow project showing a continued decline in performance on the 85 percent four-hour A&E standard, which stood at 78.14 percent for the third week of December, down from 81.52 percent 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 percent and a significant number of Trusts in England are now declaring performance of between 50 percent and 69 percent.”
Delayed transfers of care and cancelled elective operations were on the rise week-on-week, signaling further pressures on the system.
“With all but five hospitals in England running at above the recommended safe bed occupancy level of 85 percent and almost a fifth running at 99 percent, 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.”