Derbyshire’s health system moves to highest alert level - as operations cancelled

The Derbyshire health system has been moved to its highest alert level which will include cancelling some operations.
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All health authorities in Derbyshire, including Chesterfield Royal Hospital have been moved to Opel 4 due to rising pressure on the health system as a whole.

This rarely happens outside of winter and is a clear indicator of the strain staff are dealing with.

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The last time Opel 4 was formally declared in Derbyshire, it is believed, was in early June due to staff shortages at the Derby Arena mass vaccination centre.

Chesterfield Royal Hospital.Chesterfield Royal Hospital.
Chesterfield Royal Hospital.

The current issue, which is leading to hospital staff having to be redeployed and the cancellation of some operations, has been caused by a litany of issues.

Our hospitals are dealing with an influx in Covid-19 inpatients, with Chesterfield Royal, the Royal Derby and Queen’s Hospital in Burton catering for 77 patients with the virus.

This is 50 per cent more than two weeks ago.

At the same time, “exhausted” and “burned out” staff are wading through a crippling waiting list backlog, with thousands of patients now having waited more than a year for treatment, when usually no patient would wait that long.

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Staff are also being depleted through contracting Covid themselves.

A&E attendance at our hospitals is as high as it usually reaches in the winter, and in some instances, leaders say, this includes people attending for coughs and colds – which can be treated elsewhere.

Such is the strain on services that at one point in July, East Midlands Ambulance Service received 5,000 calls in a single day – with 2,500 typically deemed a “challenging” day.

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Each day throughout July, EMAS says, has seen around 1,000 calls for service.

This is 40 per cent higher than in July 2019 – before the pandemic – with most days busier than the traditionally hectic days, including New Year’s Eve.

Leaders also say pressure at the children’s emergency department at the Royal Derby has seen a huge increase in attendances.

These have been linked to concerns over RSV, a common respiratory virus that usually causes mild, cold-like symptoms, and bronchiolitis, typically causing mild respiratory illness.

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Type one attendances (the most urgent) at the children’s emergency department at the Royal Derby were up to an average of 125 per day during July, compared to 94 in July 2019 – the last comparable year.

On July 8 alone the department saw 163 attendances.

A&E teams are seeing increasing numbers of patients, with 1,038 patients in just one day this Monday, September 6, at Chesterfield Royal, Royal Derby Hospital and Queen’s Hospital, Burton.

Berenice Groves, chief operating officer at Chesterfield Royal Hospital, said: “We want to offer the best care to all of our patients whether it’s via A&E so they get the urgent care they need or a specialist team to treat cancer or other urgent conditions.

“We’re having to redeploy staff from our operating theatres to work in critical care units, which unfortunately means we need to cancel some operations.

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“If you’re called with a cancellation then we know this will be disappointing.

“Please be assured we are only doing this where necessary and feel we have little alternative. Please try to be understanding when our staff call.”

“Families can also really help us by supporting their loved ones to go home whilst they await a care package or accept a placement in a care home.

“We know this is not ideal and we are grateful to families for continuing to do everything they can to support loved ones to return home so we can get patients who really do need to be in hospital into a bed quicker.”

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“We are also having to take extra steps to discharge patients to the first available residential or nursing home bed, which in some cases may not be the bed closest to the patient’s home.“We would appreciate families’ support with this to help us ensure we can prioritise hospital treatment for those patients who are the most poorly.”

Brigid Stacey, chief nursing officer for NHS Derby and Derbyshire Clinical Commissioning Group (CCG), said: “All our staff working in health and care services are trying to make sure we see people who need us.”

“Pressure is on every part of the health and care system from our GPs working tirelessly to return every call to a patient in need, to beds being limited in care homes due to staffing shortages and outbreaks of illnesses.

“As always we are working together as a system to do everything we can to make sure we get the care to everyone who needs it.“We need the public to help us and this might include helping us when patients are ready for discharge from hospital.”

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Dr Magnus Harrison, medical director at University Hospitals of Derby and Burton NHS Foundation Trust, said: “We are here for patients who have a major, life changing or life threatening illness.

“Colleagues at Urgent Treatment Centres and NHS 111 online can provide advice for other illness or injury.“Please also, where possible, make your own way to hospital where this is safe rather than relying on an ambulance via 999.

“People turning up at hospitals with minor illnesses are waiting a very long time for treatment.

“We have seen people who have attended A&E with coughs and colds, which can be easily treated by a pharmacist or at home.

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“For more advice and guidance, visit 111.co.uk who can direct you to the most appropriate service.

“We are asking people to use the most appropriate services available to them for anything that is not life threatening and if you are unsure visit 111 online.

“GPs are open and pharmacies can help with advice and give many over the counter solutions to colds, tummy troubles and rashes.

“Our urgent treatment centres are a good alternative to A&E if your injury is not life-threatening.

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“They can treat you for serious conditions such as minor head bumps and suspected broken bones.”

Brigid Stacey added: “We have been so grateful for the public support throughout the pandemic. We have been overwhelmed by kindness and thoughtful gestures.

“We know the public are incredible in their support and the biggest thing they can do now to help us, is to think about how they use our services, to help us to help you.

“Our local GPs, urgent treatment centres and pharmacists are incredible and offer excellent treatment.

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“There are evening appointments available and the waits are much shorter for minor ailments.

“We don’t want people to wait and we want to offer the best care we can, but saving lives is the main job of A&E and we must always prioritise life.

“And we also need support from families in helping to discharge patients when they are ready and to accept that they may not necessarily go to the care home you’d normally choose.”

In the most recent week of data, Derbyshire saw more than 4,300 Covid-19 cases, a level it last hit in the week following “Freedom Day” when legal restrictions over face coverings and social distancing were lifted.

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It is a similar number of weekly cases as we saw at the height of the winter peak in January, though that saw more than 700 people hospitalised – before the full roll-out of vaccines.

However, Derbyshire is now seeing more people hospitalised with Covid-19 than it saw this time last year, with 77 people now in our hospitals with the virus, while there were fewer than 10 patients with the virus in our hospitals in early September in 2020.

Likewise, this time last year, Derbyshire was seeing fewer than 260 cases of the virus per week – now it is seeing more than 4,300, more than 16 times that figure.