NHS hospitals ordered to cancel all routine operations in January as flu spike and bed shortages lead to A&E crisis

Laura Donnelly
The instructions will result in 50,000 operations such as cataract, hip and knee surgery being cancelled  - PA 

Every hospital in the country has been ordered to cancel all non-urgent surgery until at least February in an unprecedented step by NHS officials.

The instructions on Tuesday night - which will see result in around 50,000 operations being axed - followed claims by senior doctors that patients were being treated in “third world” conditions, as hospital chief executives warned of the worst winter crisis for three decades.

Hospitals are reporting growing chaos, with a spike in winter flu leaving frail patients facing 12-hour waits, and some units running out of corridor space.

Sir Bruce Keogh, NHS medical director, on Tuesday ordered NHS trusts to stop taking all but the most urgent cases, closing outpatients clinics for weeks as well as cancelling around 50,000 planned operations.

Trusts have also been told they can abandon efforts to house male and female patients in separate wards, in an effort to protect basic safety, as services become overwhelmed.

Why is the NHS under so much pressure?

The chaos follows a rise in flu cases when many hospitals were already close to capacity, with high numbers of frail patients stuck on wards for want of social care.

By Tuesday night 12 NHS trusts - including two ambulance services covering almost nine million people - had declared they had reached the maximum state of emergency.

One ambulance trust resorted to taxis to ferry patients to hospital, while another asked patients to find a family member to get them to hospital, with paramedics stuck outside A&E units in record numbers.

Health officials said pressures on the NHS were expected to continue to rise, with flu levels surging.

Sir Bruce Keogh, NHS medical director, said more action needed to be taken to tackle waiting lists Credit: Christopher Jones

Sir Bruce 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.”

Successive governments have banned mixed-sex wards, in a bid to protect patients’ dignity.

The decision to relax the rules was last night seen as a desperate measure, as pressures mount.

In Staffordshire, one senior consultant said vulnerable patients were now being treated in “third world conditions” amid mass overcrowding.

Dr Richard Fawcett, a consultant in emergency medicine at Royal Stoke hospital, said it broke his heart to see elderly and frail people lining NHS corridors.

The Army doctor, who has done three tours of Afghanistan commanding a field hospital, tweeted a personal apology to patients: 

North East Ambulance Service is among trusts declaring the highest state of alert, warning that its “response standards to potentially life-threatening calls have deteriorated”.

The trust said it had received 19,000 calls to 999 in the week which just ended - one quarter more than the same time last year - while coping with 40 per cent more 111 calls.

Some patients who would normally be sent an ambulance were now being asked if they could make their own way to hospital, with help from relatives, the trust said.  

East of England Ambulance Service, also at maximum capacity, said some patients were being sent taxis to get them to hospital, with paramedics stuck in ambulances queuing at hospitals for more than 500 hours in the last four days.

'Black alerts'

In addition, 10 hospital trusts said they were at the highest level of pressure - better known as a “black alert” - under a four-point scale of “Operational Pressures Escalation Levels” used to bring emergency plans into motion, when patient safety is at risk.

Among those admitting they had now reached this level of pressure were: 

  • Dartford and Gravesham NHS Trust
  • Royal Cornwall Hospitals 
  • Portsmouth Hospitals NHS
  • Maidstone and Tunbridge Wells
  • Medway NHS Foundation Trust
  • University Hospitals Of Leicester
  • Epsom and St Helier University Hospitals
  • Taunton & Somerset Foundation Trust
  • Yeovil District Hospital Foundation Trust
  • Royal United Hospitals Bath  

Many more trusts refused to provide information about pressure levels, with several saying NHS England no longer allowed them to divulge the information, which used to be published in previous winters.  Officials have also stopped weekly updates of data showing how A&E units are performing against the four-hour target.

However, an audit by the Royal College of Emergency Medicine (RCEM) suggests that ahead of Christmas, less than 81 per cent of patients were being seen within four hours - against a target of 95 per cent. The figure is the worst recorded since the college began tracking A&E units three years ago.

The RCEM audit of more than 50 hospitals also revealed thousand of operations cancelled during Christmas week, with 70 per cent more cancellations this year compared with last.

A number of NHS trust chief executives described the pressure as “relentless” with several on Tuesday saying they had never seen such pressure during 30 years in the health service.

Dr Nick Scriven, president of the Society for Acute Medicine, said: "The position at the moment is as bad as I've ever known. We are simply not coping, we were at full capacity before the sorts of pressures that we should be able to manage - like a rise in flu - is pushing us over the edge.

“Things are terrible now, but I am fearful the next few weeks will be horrendous."

 

 

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