Pressure on hospital capacity is already reaching levels normally seen later in the year, sparking fears from nurses that the NHS will struggle to cope more than usual this winter.
Official figures show patient waiting times were approaching winter levels by the end of September, and Nursing Times has learnt that ward managers at one trust have raised concerns about patient safety due to lack of beds.
Department of Health figures for July to September show about 21,000 accident and emergency patients waited more than four hours for a bed, equivalent to 2.6% of all emergency admissions. This compares with 1.9% in the same period in 2010 and 1.2% in 2009.
Annual data trends suggest rates for July to September are likely to double during December to March.
Royal College of Nursing urgent and emergency care adviser Alan Dobson said the increases were being driven by hospitals closing beds without capacity being created elsewhere in the system, for example the community.
“We are getting lots of reports that there is extreme pressure out there in all areas of emergency care but particularly around capacity to admit patients. It’s going to get worse [in the winter]. Nurses are saying they’re very worried about it,” he said.
Nursing Times has seen an anonymous letter sent to the RCN by a group of concerned sisters and charge nurses running an over stretched A&E department who are being forced to leave patients on trolleys.
They write: “As a caring professional group …we are very concerned about the safety of the patients being brought to our department, as there is often no cubicle space for them to be assessed in. New patients often start on a trolley in a corridor with no privacy.”
They say their hospital has lost 56 beds this year due to two ward closures.
“Over the summer months we have seen an increase in demand with less beds in the hospital and we find our department full of patients that we cannot move on due to insufficient capacity,” the say.
“We are all used to working hard. We never refuse an ambulance regardless of our circumstances. This places us under intense pressure,” they add.
Last week the Department of Health launched Winterwatch – an online facility monitoring the impact of winter pressures, including flu, on A&E departments.
The DH figures for July to September show East Surrey Hospital as having the worst performance, with 26.6% of patients admitted through A&E waited more than four hours for a bed.
Michael Wilson, chief executive of Surrey and Sussex Healthcare Trust, which runs the hospital, said the trust had initiated a £14m building programme to increase capacity. More nurses have also been introduced into the emergency department and hourly comfort rounds have been introduced for waiting patients.