How is your local NHS coping under winter pressures?
Pressure on hospitals is particularly high this winter, with more than a dozen declaring critical incidents in recent days.
Hospitals struggle every winter with additional pressures due to the impact of cold weather, but the early arrival of flu this season and high volume of cases meant Christmas and New Year’s weeks were even busier than usual.
There are currently at least 20 hospitals that have declared critical incidents in England, although this is a fast-moving picture, and some trusts will go into critical incident for as little as half an hour.
The latest NHS winter situation reports give a more detailed look at the level of pressure experienced by individual trusts, including those with the worst ambulance handover delays and highest levels of flu patients.
Ambulance handover delays
When a patient arrives at a hospital in an ambulance, clinical guidelines suggest that it should take no longer than 15 minutes to transfer them into emergency care.
It is now common for handovers to regularly exceed this timeframe, however, when emergency departments are overcrowded and lack the capacity to keep up with new patient arrivals.
This is risky for patients because it delays their assessment and treatment by clinicians, and also reduces the availability of ambulances to respond to new incidents.
The trust with the longest delays was University Hospitals Plymouth, with an average handover time of three hours and 33 minutes over the week – two hours and 40 minutes longer than the average for England. It also recorded the longest average handover times for a single day, at five hours and 14 minutes on New Year’s Day.
Use the table below to search for local ambulance handover times:
On 7 January, University Hospitals Plymouth declared a critical incident at Derriford Hospital due to “significant and rising demand for hospital care”, though this has since been stood down.
The Shrewsbury and Telford Hospital Trust had an average ambulance handover time of three hours and 15 minutes, increasing by more than an hour from one hour and 51 minutes the week before.
In Royal Cornwall Hospitals NHS Trust, 83% of handovers took more than 30 minutes, the highest share among areas dealing with more than five ambulance arrivals per day.
This area also recently declared and then stood down a critical incident.
In total across England, 43 trusts out of 127 had average handover times of more than an hour, while nine areas had average handover times of more than two hours.
Flu
This winter’s flu wave arrived earlier than usual and has hit health services hard.
Over New Year’s week, there were 5,407 flu patients in hospitals in England on average each day, more than three times higher than during the same week last year and increasing by 20% from the week before.
The worst impacted trusts were Northumbria Healthcare and University Hospitals Birmingham, with 15% and 13% of all available beds occupied by flu patients respectively in the latest week.
Wirral University Teaching Hospital NHS Foundation Trust had among the biggest increase in flu patients from the previous week, more than doubling from 18 to 42 patients per day on average.
Use the table below to search for local flu hospitalisations:
There are some indications that flu activity may have now peaked, with national flu surveillance showing a decrease in positive flu tests in the latest week, though activity remains at high levels.
Bed occupancy
Current NHS guidance is that a maximum of 92% of hospital beds should be occupied to reduce negative risks associated with overfilled beds.
These risks include the impact on patient flow resulting from it being more difficult to find beds for patients, and negative impacts on performance and waiting times, as well as being linked to increased infection rates.
In the week to 5 January, 92.8% of 102,546 open hospital beds were available each day on average, not far off the recommended level.
However, bed occupancy was very high in some trusts, with more than 95% of beds occupied in 43 trusts on average over the week.
The trust with the highest rate of bed occupancy was Wye Valley NHS Trust, with 99.9% of 332 beds occupied on average throughout the week.
There was only one day when beds weren’t fully occupied, on 3 January, when two beds of 322 were available.
Use the table below to search for local bed occupancy:
Kettering General Hospital NHS Trust recorded bed occupancy of 98.5% over the week. This trust declared a critical incident on 8 January.
Part of the problem for bed availability is prolonged hospital stays – also known as bed-blocking.
This is often linked to pressures in other parts of the health and social care system, for example when patients can’t be discharged to appropriate social care providers even though they are ready to leave hospital.
Just under half of beds occupied by patients in English hospitals last week were occupied by long-stay patients who had been there for seven or more days.
In seven trusts, at least three in five beds were occupied by long-stay patients, while in Barking, Havering and Redbridge University Hospitals NHS Trust the figure was more than four in five beds.
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A new public inquiry will “uncover the truth” behind the so-called “Battle of Orgreave”, a bloody fight between striking miners and police officers in the 1980s.
One hundred and twenty people were injured in the violent confrontation on 18 June 1984, outside a coal processing factory in Orgreave, South Yorkshire.
Five thousand miners clashed with an equal number of armed and mounted police during a day of fighting.
Police used horse charges, riot shields and batons against the picketers, even as some were retreating.
Masses of miners and police clashed during the day of fighting
Police officers on horses charged against protesters
In the aftermath, miners were blamed for the violence in what campaigners believe was an institutional “frame-up”.
“There were so many lies,” says Chris Peace, from campaign group Orgreave Truth and Justice, “and it’s a real historic moment to get to this stage.”
“There’s a lot of information already in the public domain,” she adds, “but there’s still some papers that are embargoed, which will hopefully now be brought to light.”
Campaigner Chris Peace
Although dozens of miners were arrested, trials against them all collapsed due to allegations of unreliable police evidence.
Campaigners say some involved have been left with “physical and psychological damage”, but until now, previous governments have refused calls for a public inquiry.
Launching the inquiry today, Home Secretary Yvette Cooper told Sky Newsi that she wanted to “make sure” campaigners now got “proper answers”.
“We’ve obviously had unanswered questions about what happened at Orgreave for over 40 years,” Ms Cooper says, “and when we were elected to government, we determined to take this forward.”
A police officer tackling a miner
A bleeding protester being led away by police during the ‘Battle of Orgreave’
The Bishop of Sheffield, Pete Wilcox, will chair the inquiry
The inquiry will be a statutory one, meaning that witnesses will be compelled to come and give evidence, and chaired by the Bishop of Sheffield, Pete Wilcox.
“I’m really happy,” says Carl Parkinson, a former miner who was at Orgreave on the day of the clash, “but why has it took so long?”
“A lot of those colleagues and close friends have passed away, and they’ll never get to see any outcome.”
Former miner Carl Parkinson
Former miner Chris Skidmore
Mr Parkinson and Chris Skidmore, who was also there that day, were among the group of campaigners informed first-hand by Ms Cooper about the public inquiry at the Orgreave site.
“It wasn’t frightening to start off with,” Mr Skidmore remembers of the day itself, “but then what I noticed was the amount of police officers who had no identification numbers on. It all felt planned.”
“And it wasn’t just one truncheon,” says Mr Parkinson, “there were about 30, or 40. And it was simultaneous, like it was orchestrated – just boom, boom, boom, boom.
“And there’s lads with a split down their heads for no good reason, they’d done nothing wrong. We were just there to peacefully picket.”
Police used riot shields against the picketers, even as some were retreating
In the aftermath of the fighting, miners were blamed for the violence
In the intervening years, South Yorkshire Police have paid more than £400,000 in compensation to affected miners and their families.
But no official inquiry has ever looked at the documents surrounding the day’s events, the lead-up to it and the aftermath.
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“We need to have trust and confidence restored in the police,” says South Yorkshire Mayor Oliver Coppard, “and part of that is about people, like this campaign, getting the justice that they deserve.
“Obviously, we’ve had things like Hillsborough, CSE [Child Sexual Exploitation] in Rotherham, and we want to turn the page.”
Consumers will get stronger protections with a new water watchdog – as trust in water companies takes a record dive.
Environment Secretary Steve Reed will announce on Monday that the government will set up the new water ombudsman with legal powers to resolve disputes, rather than the current voluntary system.
The watchdog will mean an expansion of the Consumer Council for Water’s (CCW) role and will bring the water sector into line with other utilities that have legally binding consumer watchdogs.
Consumers will then have a single point of contact for complaints.
Politics latest: Labour should let water companies ‘go bust’, Farage says
The Department for the Environment, Food and Rural Affairs (Defra) said the new watchdog would help “re-establish partnership” between water companies and consumers.
A survey by the CCW in May found trust in water companies had reached a new low, with fewer than two-thirds of people saying they provided value for money.
Just 35% said they thought charges from water companies were fair – even before the impact could be felt from a 26% increase in bills in April.
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‘We’ll be able to eliminate sewage spillages’
Mr Reed is planning a “root and branch reform” of the water industry – which he branded “absolutely broken” – that he will reveal alongside a major review of the sector on Monday.
The review is expected to recommend the scrapping of water regulator Ofwat and the creation of a new one, to incorporate the work of the CCW.
Read more:
Labour will eliminate unauthorised sewage spillages in a decade
Under-fire water regulator could be scrapped
A water pollution protest by Surfers Against Sewage in Brighton
Campaigners and MPs have accused Ofwat of failing to hold water operators to account, while the companies complain a focus on keeping bills down has prevented appropriate infrastructure investment.
On Sunday, Mr Reed avoided answering whether he would get rid of Ofwat or not when asked on Sunday Morning with Trevor Phillips.
He pledged to halve sewage pollution by water companies by 2030 and said Labour would eliminate unauthorised sewage spillages in a decade.
Mr Reed announced £104 billion of private investment to help the government do that.
Victoria Atkins MP, Shadow Secretary of State for Environment, Food and Rural Affairs, said: “While stronger consumer protections are welcome in principle, they are only one part of the serious long-term reforms the water sector needs.
“We all want the water system to improve, and honesty about the scale of the challenge is essential. Steve Reed must explain that bill payers are paying for the £104 billion investment plan. Ministers must also explain how replacing one quango with another is going to clean up our rivers and lakes.
“Public confidence in the water system will only be rebuilt through transparency, resilience, and delivery.”
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