Hospital pressures: West Midlands health bosses consider 'levers' they could pull as winter bites
Action is to be taken to stop ambulances being stuck outside hospitals in the Black Country and Birmingham as winter pressures take hold.
NHS bosses said a number of measures could be implemented to ease the strain on emergency departments and free up beds as hospitals battle to cope with demand.
On Monday (December 8), University Hospitals Birmingham NHS Foundation Trust declared a critical incident after 269 inpatients, including nine critical, were presented to busy A&E departments.
The previous Monday (December 1) a third of all West Midlands ambulances were stuck outside hospitals waiting to admit patients at some point.
This included ‘category two’ ambulance responses for patients who had suffered chest pain or strokes left waiting for more than 30 minutes.
Around 20 queuing ambulances waiting to drop off patients were filmed outside Dudley's Russells Hall A&E unit.
Things are expected to get worse in the coming weeks as winter tightens its grip while resident doctors are planning to take further industrial action from December 17.
Members of the joint NHS Birmingham and Solihull and NHS Black Country Integrated Care Board (ICB) were told several ‘levers’ could be pulled to try to ease the pressure.
David Melbourne, chief executive, said one option would be to commission services to implement winter plans earlier than normal, including utilising potential capacity at the Midland Metropolitan Hospital in Smethwick.
A second measure could be to deploy GPs at ‘front doors’ of hospitals to help and support with demand while a third option would be for the ICB to provide support to discharge patients.
Mr Melbourne said: “If you look at East Midlands Ambulance Service and West Midlands Ambulance Service, they have two different challenges.
“East Midlands have fewer trucks and ambulances and therefore what you tend to get is people waiting for an ambulance for over an hour.
“In the West Midlands, we have more trucks and therefore you get fewer people waiting for longer in the community.
“But what that does mean in the West Midlands is you see more ambulances at the hospitals and the issue we are facing is we are seeing a lot more ambulances sitting outside our A&E departments.
“Last Monday [December 1] a third of all the West Midlands ambulances were sitting outside A&E departments somewhere across the region. Therefore, those crews were not able to get back out.
“And how long [people] waited in an ambulance for strokes had gone up to over 31 minutes. That’s still better than the East Midlands but still not good enough.
“The challenge we’ve therefore got is what levers do we have to support and help particularly as we move towards a period where we have an increase in flu, a period where resident doctors are going back on strike in December 17?”
