Over 60% of NHS trusts in England 'issued high-level alerts this winter'

Sarah Marsh and Pamela Duncan
British Red Cross described a humanitarian crisis in emergency NHS care this winter. Photograph: Christopher Furlong/Getty Images

More than 60% of NHS trusts in England had to declare high-level alerts at some point this winter, meaning they were under major pressure or unable to guarantee patient safety.

According to newly released data, 37 trusts – almost a quarter of the total – reported one or more Opel 4s between December and February, meaning they were so overcrowded safety could not be assured. In the same time period, 93 trusts reported Opel 3s – meaning they were facing major pressures – on 1,394 separate occasions.

In a year when the British Red Cross described a humanitarian crisis in emergency NHS care, Friday’s data release reveals the range of the strain placed on hospitals. Some 62,000 beds were closed due to norovirus during the winter, ambulances were turned away from hospitals 476 times, and the NHS recorded one A&E closure.

Graphic showing the number of Opel 3 and Opel 4 alerts recorded by NHS England this winter

The hospital trusts reporting the greatest strain include Salisbury NHS foundation trust, with 47 alerts, six of which were the highest escalation level. The university hospitals of Leicester NHS Trust had a lower level of overall alerts – 42 – but 27 were the highest level of emergency. They have been on some level of alert every day for which information is recorded since the end of January.

The figures reflect a winter filled with reports of spiralling pressures on health and social care services including a record number of cancelled routine operations, reports of chronic bed shortages and patients dying due to long waits for care.

A leaked document showed a record number of patients spent longer than the target time waiting to be seen in emergency wards in January.

Guidance from NHS England, issued last October, tells hospital trusts to signal an Opel 4 alert when the trust needs to take “decisive action ... to recover capacity and ensure patient safety” due to pressure on the system. The move allows them to request external support where necessary.

Dr Mark Porter, council chair of the British Medical Association, said: “The NHS is doing more work than ever but the government has failed to meet the increasing demand with appropriating funding or resourcing.”

Porter said it was time the government faced up to the issues in the NHS. “It must provide a sustainable solution to the funding and capacity challenges that are pushing our health service to breaking point.”

Graph comparing winter 2016/17 to the previous two winters

Dr Taj Hassan, the president of the Royal College of Emergency Medicine, said the figures show emergency medicine is in crisis. “Performance has continued its long-term downward trend and bed occupancy has consistently hovered around the 95% mark – a great deal higher than the 85% level deemed safe.”

His words were echoed by Jonathan Ashworth, shadow secretary of state for health, who said Theresa May had lost control of the NHS this winter. Ashworth called for the government to bring forward £2bn of social care funding to take pressure off hospitals.

These figures are likely to add more pressure on the government to address a growing NHS bed shortage and funding crisis. They come after the King’s Fund said winter pressure had dealt a blow to trusts’ efforts to balance the books.

An NHS England spokesperson said frontline services had been under huge pressure this winter, and praised NHS staff for their hard work.

The Department for Health said: “The NHS treated more than 24,000 more people in A&E departments within four hours in December compared to the same month last year. We are supporting councils with up to £7.6bn of dedicated funding for social care over the course of this parliament, a significant investment to help care for our ageing population. While many local authorities are already providing high-quality social care services, we will continue to challenge and support those not currently doing so.”

The release comes a day before protesters march on Saturday against the government’s sustainability and transformation plans. The controversial proposals, which the government says will bring care back into the community, are likely to result in the closure of hospital beds and reduce services in some areas.

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