Huddersfield and Calderdale hospitals on highest alert with all beds full

All beds are full at Huddersfield Royal Infirmary and Calderdale Royal Hospital, a meeting was told yesterday (November 27), with the overarching NHS Trust operating on the highest level of alert.

The meeting of Kirklees Council’s Health and Adult Social Care Scrutiny Panel heard an update on the finances of the local health system, with this bringing to light some insights into the state of local hospitals on the ground.

Director of Finance at the Calderdale and Huddersfield NHS Foundation Trust (CHFT), Gary Boothby, said: “Speaking on behalf of CHFT, I know that we are currently in all available beds. So, we hadn’t planned to be in all the beds but we need to be because of the volume of activity that’s coming through the front door.

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“Year to date, we’ve seen an extra seven percent attendance in terms of A&E departments and we’ve seen 14 percent more non-elective activity, so those are patients that are admitted probably as a result of an attendance at A&E. That all requires us to increase our bed capacity which is causing us challenges financially.”

Councillor Eric Firth wanted to know where patients who needed to be admitted to hospital were being placed with the hospitals being full, but didn’t get a definitive answer.

Later in the meeting, it emerged that CHFT was operating at OPEL (Operational Pressures Escalation Levels) Four - the highest level of alert which signifies severe pressure. Responding to a question from Chair, Jo Lawson (Community Independent, Crosland Moor and Netherton), Vicky Dutchburn, Director of Operational Delivery and Performance for Kirklees ICB, highlighted pressures around Norovirus and RSV and said the closure of wards had tipped the Trust into an OPEL Four.

In addition, 20 percent of patients across the Trust’s hospitals were said to have no need to reside there, being deemed medically fit to be discharged, with this figure standing at 17-18 percent in the Summer. Co-optee, Kim Taylor, wanted to know the reasons behind this.

Ms Dutchburn explained that there are a number of factors impacting this figure - whether there’s support at home, transport needing to be arranged, the need for extra tests or outstanding results coming back - with patients sometimes swapping from being considered medically fit to then needing to be kept in hospital.

She said that everybody who is staying in hospital is at some point considered to have no reason to reside there because discharge doesn’t take place immediately. However, the average length of time a person remains in hospital after being deemed medically fit stands at around four days.

During his presentation on finances, Mr Boothby said that CHFT, the Mid Yorkshire Teaching NHS Trust (MYTT), and Locala had planned to end the year with a combined deficit of £6.75m, but for this to happen, savings of £125.6m had to be made. He said that at month seven, the partners are behind the plans by around £12m, with a deficit of £18.22m, against the £5.86m forecast for this time.

The meeting heard that the challenges driving the deficit are no different to those faced across West Yorkshire and nationally, with pressures on primary care and continuing healthcare budgets, pressures around pay awards and increased demand for services, particularly in A&E departments, flagged as just some of the difficulties.

Despite these challenges, CHFT is hoping to end the year with its planned £1.25m deficit. However, the same can’t be said for MYTT which covers Dewsbury and Wakefield, which needs to address financial challenges of up to £15m.

An underlying deficit will be carried over into the next year, with the organisations said to be looking at “pathway redesign” to help reduce the financial pressures. Co-optee, Ms Taylor, wanted to know what was meant by this term and whether this would result in vacancy controls and certain services being stopped.

Mr Boothby explained that it was a case of using resources “as efficiently as possible”. He said that there are already tight vacancy control processes in place which includes freezing recruitment to some posts, though this has to be done 'carefully' and 'sensibly' to avoid a negative impact on patients.

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