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You can find the current article at its original source at https://www.theguardian.com/society/2018/jan/04/organised-chaos-staff-at-ipswich-hospital-ae-on-an-intense-week
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| 'Organised chaos': staff at Ipswich hospital A&E on an 'intense' week | 'Organised chaos': staff at Ipswich hospital A&E on an 'intense' week |
| (about 1 month later) | |
| It is 11am in A&E at Ipswich hospital, Suffolk, and the department is unusually quiet after a busy week. A combination of bad weather and more patients suffering breathing problems led to a deluge of arrivals over Christmas and new year. Today, staff look hollow-eyed with exhaustion as they move between checking on patients and doing paperwork. | It is 11am in A&E at Ipswich hospital, Suffolk, and the department is unusually quiet after a busy week. A combination of bad weather and more patients suffering breathing problems led to a deluge of arrivals over Christmas and new year. Today, staff look hollow-eyed with exhaustion as they move between checking on patients and doing paperwork. |
| Doctors and nurses talk about the past few days being among the most intense in their working life and say they are exhausted. Many have worked long, unrelenting shifts. The hospital was forced to open escalation wards, and cancelled all elective surgery in preparation. An average of 259 patients attended A&E each day from 19 December to 2 January, up from 232 last year – a rise of 11%. The hospital is now running at 90% capacity. | Doctors and nurses talk about the past few days being among the most intense in their working life and say they are exhausted. Many have worked long, unrelenting shifts. The hospital was forced to open escalation wards, and cancelled all elective surgery in preparation. An average of 259 patients attended A&E each day from 19 December to 2 January, up from 232 last year – a rise of 11%. The hospital is now running at 90% capacity. |
| We will be monitoring the situation in hospitals over the next few months and want to hear your experiences of the NHS this winter. We are keen to hear from healthcare professionals as well as patients about the situation. Have operations been cancelled? Has pressure led to certain wards being closed? How are staff coping? Help us document what is going on across the UK. | We will be monitoring the situation in hospitals over the next few months and want to hear your experiences of the NHS this winter. We are keen to hear from healthcare professionals as well as patients about the situation. Have operations been cancelled? Has pressure led to certain wards being closed? How are staff coping? Help us document what is going on across the UK. |
| “I can only describe it as a bit like an emotional rollercoaster, we work in organised chaos. There has been some tears among the nursing staff but there has also been a team feel,” says Rebecca Siles, 37, a sister at the emergency department. | “I can only describe it as a bit like an emotional rollercoaster, we work in organised chaos. There has been some tears among the nursing staff but there has also been a team feel,” says Rebecca Siles, 37, a sister at the emergency department. |
| Today, those in one ward include a 19-year-old girl with a diabetic condition and a boy who is throwing up violently. A quick glance on the screen shows that 40 patients are waiting to be seen, only one has been there for over three hours. The picture looked very different a few days ago, Siles says. “It has been black a lot recently, which is when a patient has been waiting for over four hours.” | Today, those in one ward include a 19-year-old girl with a diabetic condition and a boy who is throwing up violently. A quick glance on the screen shows that 40 patients are waiting to be seen, only one has been there for over three hours. The picture looked very different a few days ago, Siles says. “It has been black a lot recently, which is when a patient has been waiting for over four hours.” |
| She adds: “On New Year’s morning when we came in to the department it was full … I counted 17 patients, some were waiting to go to the ward and others were waiting with the ambulance crews to get into hospital.” | She adds: “On New Year’s morning when we came in to the department it was full … I counted 17 patients, some were waiting to go to the ward and others were waiting with the ambulance crews to get into hospital.” |
| With a less chaotic A&E, staff can try to get everything back in order. “When it’s quiet we are trying to get ahead of the game. We want to reduce the time the people arriving spend in A&E so when ambulances do arrive there is space to get them into,” Siles says. | With a less chaotic A&E, staff can try to get everything back in order. “When it’s quiet we are trying to get ahead of the game. We want to reduce the time the people arriving spend in A&E so when ambulances do arrive there is space to get them into,” Siles says. |
| Ipswich is not alone in having a difficult winter, with many hospitals exceptionally busy this year. Record numbers of patients were forced to wait in the backs of ambulances last week as hospitals in England struggled with the high numbers. Drastic measures were taken across the country, including cancelling outpatient appointments and extending an existing ban on non-urgent surgery until the end of the month. | Ipswich is not alone in having a difficult winter, with many hospitals exceptionally busy this year. Record numbers of patients were forced to wait in the backs of ambulances last week as hospitals in England struggled with the high numbers. Drastic measures were taken across the country, including cancelling outpatient appointments and extending an existing ban on non-urgent surgery until the end of the month. |
| But while it has been tough, Ipswich, unlike other hospitals, has not declared a black alert – known as opel 4. Hospitals are forced to announce this when they can no longer guarantee patient safety and provide their full range of services. Also, unlike elsewhere, they have managed to get numbers down gradually since the new year and normalise the service. | But while it has been tough, Ipswich, unlike other hospitals, has not declared a black alert – known as opel 4. Hospitals are forced to announce this when they can no longer guarantee patient safety and provide their full range of services. Also, unlike elsewhere, they have managed to get numbers down gradually since the new year and normalise the service. |
| The hospital has been coping in a large part due to the fact it works closely with others in the community, according to Mark Shenton, a GP and chair of the Ipwsich and East Suffolk clinical commissioning group. “We learned from the previous year and realised a good winter plan is a good escalation plan for normal working rather than trying to do something new,” he says. | The hospital has been coping in a large part due to the fact it works closely with others in the community, according to Mark Shenton, a GP and chair of the Ipwsich and East Suffolk clinical commissioning group. “We learned from the previous year and realised a good winter plan is a good escalation plan for normal working rather than trying to do something new,” he says. |
| “We have thought about how we can prevent delays in patients getting care when they leave hospital … it’s about system partners working together as opposed to silo organisations.” | “We have thought about how we can prevent delays in patients getting care when they leave hospital … it’s about system partners working together as opposed to silo organisations.” |
| Some of the decisions they made this year included getting extra respiratory consultants, and also additional support in care homes. They also got GPs to be based in A&E, treating patients with less serious health conditions who did not require emergency support. | Some of the decisions they made this year included getting extra respiratory consultants, and also additional support in care homes. They also got GPs to be based in A&E, treating patients with less serious health conditions who did not require emergency support. |
| However, winter is not over yet. Rebecca Pulford, 45, associate director of nursing, came in on New Year’s Day at 8.30am and went home at 6pm on 2 January. “I did sleep between about 1am to about 5am but I decided to book an on-call room so I could slip my scrubs on [if I was needed]. | However, winter is not over yet. Rebecca Pulford, 45, associate director of nursing, came in on New Year’s Day at 8.30am and went home at 6pm on 2 January. “I did sleep between about 1am to about 5am but I decided to book an on-call room so I could slip my scrubs on [if I was needed]. |
| “I don’t think we are out of it yet. I am not quite sure whether we are in the eye of the storm or we are in an oasis, but we have an opportunity so today we are doing things slightly differently. I really need to close beds today to give capacity over the weekend. Next week should start to get easier as all schools start the new year. There will also be more availability of agency staff.” | “I don’t think we are out of it yet. I am not quite sure whether we are in the eye of the storm or we are in an oasis, but we have an opportunity so today we are doing things slightly differently. I really need to close beds today to give capacity over the weekend. Next week should start to get easier as all schools start the new year. There will also be more availability of agency staff.” |
| She adds: “When you start to get in to bed pressures like we are, it will be a minimum 10 days before we get out of it … I was on call last night but slept because everyone had a bed … it was good.” | She adds: “When you start to get in to bed pressures like we are, it will be a minimum 10 days before we get out of it … I was on call last night but slept because everyone had a bed … it was good.” |
| Despite her positivity, however, she admits that changes are needed in the future. “I don’t think we can carry on working like we are working because the problem will just be another worse winter, another worse winter … we have got to get social care and community care provision and mental health provision out there sustainable and we need to value those people out there caring for those individuals and GPs. | Despite her positivity, however, she admits that changes are needed in the future. “I don’t think we can carry on working like we are working because the problem will just be another worse winter, another worse winter … we have got to get social care and community care provision and mental health provision out there sustainable and we need to value those people out there caring for those individuals and GPs. |
| “I don’t think the NHS can cope with the model we have now and I think there are talented people around to do things differently, which is needed.” Does she have a message for the government? “Care as much for staff as you do for the patients … and listen.” | “I don’t think the NHS can cope with the model we have now and I think there are talented people around to do things differently, which is needed.” Does she have a message for the government? “Care as much for staff as you do for the patients … and listen.” |
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