Hospital Dr News

NHS England tells trusts to defer elective work and concentrate on the front door

NHS England has told hospitals to delay elective procedures and routine outpatient appointments to concentrate on emergency care.

Up to 55,000 non-urgent NHS operations and procedures in England may be deferred until 31 January, due to winter pressures.

But NHS England reiterated that cancer operations and time-critical procedures should go ahead as planned.

The advice comes as many NHS trusts struggle to meet the New Year demand.

NHS England’s National Emergency Pressures Panel, which met for the second time on Tuesday, said it had extended the deadline for deferral of all non-urgent inpatient elective care – such as hip or knee replacements – to 31 January, to free up capacity for the sickest of patients.

NHS England also gave hospitals the green light to put patients in mixed sex wards.

The panel noted that the NHS has been under sustained pressure over the Christmas period with high levels of respiratory illness.

High bed occupancy levels are giving many trusts limited capacity to deal with demand surges, and there are early indications of increasing flu prevalence.

The panel said the clinical time released from the above actions should be re-prioritised to:

  • Implement consultant triage at the front-door so patients are seen by a senior decision maker on arrival at the Emergency Department.
  • Ensure consultant availability for phone advice for GPs.
  • Maximise the usage of ambulatory care and hot clinic appointments as an alternative to Emergency Department attendance and/or hospital admissions.
  • Increasing support from Allied Health Professionals, for example physios and therapists, for rehabilitation and discharge.
  • Staff additional inpatient beds.
  • Ensure twice daily review of all patients to facilitate discharge.
  • To ensure patient safety comes first CCGs should temporarily suspend sanctions for mixed sex accommodation breaches.

It also called on the public to play their part by using the NHS responsibly. Calling 111 is often a quicker and more convenient way of obtaining clinical assessment and advice in non-emergencies and allows staff in A&E to focus on the sickest patients, it said.

Sir Bruce Keogh, NHS England Medical Director, said: “I want to thank NHS staff who have worked incredibly hard under sustained pressure to take care of patients over the Christmas. We expect these pressures to continue and there are early signs of increased flu prevalence.

“The NHS needs to take further action to increase capacity and minimise disruptive last minute cancellations.”

Dr Richard Fawcett, an emergency medic at the Royal Stoke hospital in Staffordshire, tweeted: “As an A&E consultant at University of North Midlands NHS Trust I personally apologise to the people of Stoke for the third world conditions of the department due to overcrowding.”

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