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NHS crisis: planning for winter pressures is paying off - so far

Wiltshire Clinical Commissioning Group’s board was told on Tuesday (January 23) that their intensive planning for this winter’s pressures is having positive results in the county’s hospitals.  

In the period December 1 to January 4 - including the crucial weeks over Christmas and the New Year - attendances at Great Western Hospital’s emergency department - or A&E - were down on last year.

It is never as straightforward as that: the target requiring A&E staff to see and treat patients within four hours is still far from being met - even though fewer people were coming through the front door.

This appears to be because many of those who are going to A&E have greater acuity - have more serious and complex conditions. That is something that comes - and comes increasingly - when people are living longer.

Some of the easing in numbers attending A&E is due to the availability of alternatives such as urgent care centres and to guiding patients directly to other hospital departments. 

The number of calls to NHS 111 by Wiltshire residents was higher than over the same period last winter. But calls were much as predicted with peaks before and after Christmas Day and over the three days over New Year. NHS 111 staff were rostered to deal with these expected peaks. 

Calls to the South West Ambulance Service were 10.5 per cent up on the same period in 2016-2017.

Another piece in the NHS crisis jigsaw is the all too familiar problem of delayed transfers of care (DTOCs) - beds blocked when patients fit enough to leave hospital cannot be moved to recuperation beds, care homes or safely back to their own homes.

And blocked beds mean that A&E patients who need those beds have to wait for them. DTOCs have dropped at GWH.  But the prize went to Wiltshire’s community health provider - Wiltshire Health and Care - which returned a significant zero figure for bed days lost to DTOCs for the week ending January 18.  That achievement includes Savernake’s Ailesbury ward.

The CCG’s board was warned that the number of DTOCs might be beginning to edge up again.

But - again there’s a ‘but’ - February is often an even more critical month for hospitals and this year it could well be the month that flu takes hold.

To date Wiltshire has so far had fewer flu cases than neighbouring areas to the west - notably Somerset.  But take up rates in Wiltshire for vaccinations against flu have been good.  Wiltshire was second in the country for the highest take up among two and three year-olds - fourth for those over 65 and sixth for those under 65 but in at risk groups.

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