The sitreps for the second week of February are out and the overarching pressure on the NHS is still apparent. High bed occupancy rates, high number of escalation beds open, high number of long stays over 21 days and a significant amount of beds being closed as a result of D&V or norovirus all continue into February. With the bed occupancy rate hovering at 95% for the last six weeks, the struggle to find available beds for sick patients persists.
Data around mixed sex accommodation has also been published today. Back at the beginning of January the National Emergency Pressures Panel suspended sanctions for mixed sex wards, so this is likely to also have had an impact. The number of mixed sex accommodation breaches soared in January 2018 to almost 2,000, the highest number since June 2011. This is a symptom of the pressures the NHS is under and shows that decisions to prioritise patient safety have to be taken, but perhaps at the expense of patient experience.
This week we also learn that calls to NHS 111 are up 18.3% on the same time last year. This shows that the public are using the range of services available to access the care they need, and not simply turning up to A&E.
You can find out more about what the data means in our new explainer and download our winter sitrep dashboard to see the figures in more detail.
Over winter, the spotlight has tended to be on hospital and ambulance services where winter pressures tend to be felt more acutely. But winter impacts all types of services including mental health and community.
The number of mixed sex accommodation breaches soared in January 2018 to almost 2,000, the highest number since June 2011. This is a symptom of the pressures the NHS is under and shows that decisions to prioritise patient safety have to be taken, but perhaps at the expense of patient experience.
This week we give a spotlight to mental health services, which have also been stretched this winter. We have known for several years now that many mental health services are managing inpatient demand that exceeds bed capacity, using overnight leave and out of area placements to ensure that people who need care can still receive it. But this is not optimal care. Mental health trusts are working hard to ensure that where possible people are treated in the right setting, but with capacity pressures in both inpatient facilities and in community-based services, staff resilience is under pressure too. Mental health services also face the same challenges as acute services when it comes to timely discharge, with the right social care and support packages in place. Insight into the adequacy of local provision for these services is still lacking given the highly fragmented commissioning landscape in many local areas but must be seen as broader context to the challenges facing the responsiveness of mental health services.
This week in our Provider Bites video interview, the chief executive of West London Mental Health NHS Trust, Carolyn Regan, sets out some of the challenges, and explains how the trust has responded.
Highest number of mixed sex breaches in five years are a symptom of a system under strain
NHS Providers head of analysis, Phillippa Hentsch, responded to this weeks' figures, saying:
"Very high bed occupancy, exacerbated by a rise in the number of beds closed to norovirus, will be continuing to put further strain on a system already working flat out. Bed occupancy levels have now remained above the recommended safe level throughout the winter period.
"In January, the number of patients in mixed sex wards reached its highest level since June 2011. This is a rise of 84% from this time last year, and is another symptom of a system under strain. This also follows the decision by the National Emergency Pressures Panel in January to suspend sanctions for mixed sex accommodation breaches, in order to support trusts respond to winter pressures. This is not a position trusts want to be in, but the level of demand for available beds mean that trusts have to make patient safety a priority, which may at times compromise patient experience.
"Despite this, NHS staff continue to deliver high-quality care to more patients than ever. It is positive that the time that patients are waiting in ambulances has fallen in the past week. This is alongside continued progress NHS trusts and local authorities have made in reducing the number of patients being delayed in hospital, waiting to be discharged into other care settings. This has been a priority for the health and social care system this winter."