Stories of patients being treated in corridors have hit the news this winter, as hospitals up and down the country have struggled to cope.
Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT), which runs Queen’s Hospital in Romford and King George in Goodmayes, has been far from immune to such issues, something acknowledged by chief executive Matthew Trainer during a recent board meeting.
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Following that meeting, this paper sat down with Mr Trainer and Caroline Van Luttmer, an emergency care improvement advisor, to understand more about the pressures the trust is facing.
Here are three of the key issues they said BHRUT is currently grappling with.
Increase in patients with Covid, Strep A and respiratory illnesses
Mr Trainer said one of the key challenges facing not just Queen’s but hospitals all over the country has been a rise in people coming in with Strep A, Covid and other respiratory conditions.
From December, he said parents began bringing in their children worried about symptoms such as sore throats, due to the rise in Strep A numbers.
This coincided with a hike in patients admitted with Covid, in particular those needing to be treated for Covid as the primary cause of their ill-health.
“The change we saw in the course of December was folk who started coming in with Covid that needed treating as a respiratory illness,” he said.
“And typically, old frail people or people who had other things going on, maybe they had cancer or chronic obstructive pulmonary disease (COPD) so they already had an illness, that meant that the Covid was more serious for them.
“And so, we had to start treating people for primary Covid rather than Covid as a side thing.”
Not only did this result in an increase in people being admitted but it also exacerbated pressures on the number of beds available, he added, with whole bays being used up due to the need to isolate patients.
“What it does is really it gums up the work at the hospital. And so, we've been in a period over the last six weeks or so where really the works have been pretty thoroughly gummed up at Queen's,” he said.
Staff hiring and retention
Not immune to the cost-of-living crisis, Mr Trainer said the pressure on staff’s wages and the workforce shortages currently existing in the UK market have meant holding on to staff has proven particularly difficult.
This has extended beyond the hospitals’ walls to social care, with Mr Trainer saying in one of Queen’s’ wards recently, there were three or four patients who needed to go home but were unable to as the package of care required once they left hospital was not ready, partially due to staffing.
“If you're in a position where actually you could do one of those jobs for minimum wage or you've got big retail companies and others offering really attractive packages, some people are choosing to work in other sectors other than health and care. And I think that's a challenge.”
Schemes such as providing free period products to staff, discounts on meals and giving out school uniform vouchers are among those the trust offers. Mr Trainer is also hopeful that, if a pay deal is agreed upon between government and healthcare staff, things may improve.
“I think you'd see a pretty immediate boost, actually, in terms of viability to attract and retain people.”
Use of primary care services
The issue of stretched GP resources has been reported on previously, but Mr Trainer said primary care as a whole was suffering, which in turn impacts the trust.
For example, he said around 40 per cent of the people coming into the urgent treatment centre at Queen’s could have been seen by a GP. He added he is also aware of people being directed to Queen’s after calling 111, “in circumstances where perhaps they didn't need to come to the hospital”.
He clarified he does not think patients are the issue, with most people “doing sensible things”.
Instead, he said: “We need to think about how we offer these services to allow people to make choices that don't involve coming into a really busy environment with a lot of other sick folk.
"Because the last thing you want, if you're quite honest, is to be brought into an emergency department where there's people with Covid wandering around. There's got to be better kinds of ways to care for those folks.”
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