12-hour trolley waits for 762 patients at crisis-hit Royal Stoke

A&E waiting times at Staffordshire’s main hospital have got worse – despite new staff being recruited to tackle the problem.

The Royal Stoke University Hospital saw increased ambulance handover delays of over an hour in January, with the number of patients receiving an initial assessment at A&E within 15 minutes falling to 56 per cent.

The number of patients in the emergency department for over 12 hours during the month increased to 416, and there were 762 12-hour trolley waits.

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This worsening performance came after the University Hospitals of North Midlands board approved a business case last autumn to recruit new doctors to the department.

UHNM board members grilled Jen Freer, the trust’s associate director for medicine and urgent care, over the performance figures during their monthly meeting.

She said more recent data showed that the situation had improved since January, but acknowledged that the emergency department was still facing challenges due to pressures elsewhere in the hospital.

Ms Freer told the board that actions taken to improve performance included aligning staff with key points in the day, and using A&E ‘navigators’ to speed up the assessment of some patients.

She said: “With regard to to ambulances, it would be remiss of me not to acknowledge that the delays with ambulances are significant, and at times we have been outliers across the region.

“I’d like to say that today and yesterday we haven’t had any ambulance holds, through the work we’ve been doing putting a great deal of focus into that. But it goes without saying that there is still more work to be done.

“There’s also evidence of the earlier decision-making, which is directly related to the workforce. But we do still have significant waits to be seen each morning because of the overnight workforce constrictions.”

Mr Freer said the trust had successfully recruited senior house officers to boost the A&E workforce, and the next step would be to take on ‘senior decision makers’.

She said: “They’re the key to actually getting that wait to be seen and decisions made for patients back down to where we need it to be, to allow performance in both ambulatory, non-admitted and admitted patient streams.

“That’s where the majority of our focus is. We’re looking at all sorts of innovate ways to recruit to those posts. As soon as those posts are filled, we should see that related improvement in performance. I expect to be held to account for that.”

Trust chairman David Wakefield queried why the recruitment drive had seemingly failed to make much of a difference to the January figures, and raised concerns over UHNM ‘throwing good money after bad’.

He said: “We agreed to invest quite a lot of money, on quite a lot of new doctors, and some of them have gone into A&E. But the performance has actually worsened. The last few weeks have been appalling. Can you correlate those two things for me?”

Mr Freer said there were other ‘confounding factors’ in addition to workforce issues which were affecting A&E, such as general occupancy levels and congestion within the department.

She also explained how issues elsewhere in the hospital, such as the number of medically fit for discharge (MFFD) patients, and infection prevention measures, were still limiting the flow of patients.

The number of MFFD patients at UHNM hit an all-time high of 220 in January, and while it had since fallen to 160, this is still 30 more than the worse case scenario in the trust’s winter plan.

Ms Freer said infection prevention measures for norovirus and c-diff, in addition to Covid, meant the trust lost at least a ward of capacity each day.

But she insisted that the more up-to-date figures would show a ‘dramatic improvement’ in A&E performance.

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