Hospitals under pressure after 'out-of-the-blue' 10% spike in A&E attendances

This year-on-year hike – on top of significant growth in 2018-19 – is putting pressure on those hospitals run by Northumbria Healthcare NHS Foundation Trust and bosses are puzzled as to why the increase is so high, given the figures seen across the region are fairly flat and even the national growth is only 2.4%.

At the trust’s annual members’ meeting on Wednesday (July 17), chief executive Sir James Mackey’s report on 2018-19 was largely positive.

Despite an increase in emergency department (ED) attendances of 16.5% across all sites and a rise of 14.7% at the Northumbria Specialist Emergency Care Hospital in Cramlington, Northumbria Healthcare was among the elite few acute trusts to hit the 95% ED target for seeing patients within four hours, managing 96% across the year.

Reflecting on a range of performance measures, with staff and patient experience crucial among them, he concluded: “Overall, it was a very, very strong performance.”

Turning to the first quarter of 2019-20 though, he added: “Quarter one has been one of those classic NHS things where just when you think you’re doing well, you clatter yourself into a wall.

“Quarter one has been incredibly hard right across the NHS but especially here.”

The trust did not manage to hit its ED target, managing just short of 93 per cent, although this still resulted in a position of 17th nationally – ‘but nowhere near where we want to be’.

ED attendances in Newcastle actually fell by 4.5% during the first quarter, Sir James reported, adding: “There’s something going on between the boundaries of here and Newcastle that’s driving demand, but there is also something going on in our system that we are looking at with lots of analysis to understand what’s actually happening there to drive that kind of volume.

“No organisation can withstand a 9.5%, out-of-the-blue volume growth, because this really just happened from zero around Easter time.

“We are just getting on top of it now, but it has been a very, very difficult first few months.”

He added: “We have got to continue all of these actions that we’re working through and make sure that they’re sustainable and can withstand that level of volume increase, because it’s not going to go away.”

Opening the meeting, chairman Alan Richardson said: “It’s been another very busy year – unprecedented demands on our services and on our staff.

“It worries all of us and we have got to get smarter and smarter at dealing with more and more people attending, in sicker and sicker stages, some of them.

“We are on top of it though and we continue to be on top of it.”

Later in the meeting, one member asked if the increase in A&E attendances could be partly attributed to growing waiting times for GP appointments, but Sir James said that these were not measured in the way that hospitals were so it was difficult to prove one way or the other.

Last week, the trust made an appeal for the public to think carefully before attending the emergency department at the Northumbria.

It warned that the number of people doing so had hit record levels – far in excess of even winter pressures – with long waits expected for people who did not need urgent or life-saving care.

“It’s vital that people understand the emergency department is designed for people in need of the most urgent or life-saving care – it isn’t meant to be a walk-in for any and all ailments,” said executive medical director, Dr Jeremy Rushmer.