Derbyshire health and care system remains under pressure; patients continue to be asked to not store up care needs

The Derbyshire health and care system continues to be exceptionally busy, and the declaration of critical incident remains in place while dealing with significant and sustained demand for services.  The critical incident had been declared on Tuesday 20^th December to help clinically prioritise care and maintain safe services for patients.

Wednesday and the early parts of Thursday saw the first 24 hour strike action by ambulance service members of the GMB union.  Following detailed preparation, the impact on service pressure was managed effectively, and ambulance crews were able to continue to respond to the most urgent cases. Elsewhere, hospitals saw less activity than anticipated, although this has raised concerns that there might be a wave of attendances now the first strike has finished.

Members of the public are being asked to continue to access the NHS for care in the usual manner, accepting that there may be longer waits for care in some health and care settings. Despite the high levels of demand, the NHS remains open for business and is also keen to avoid an influx of stored-up demand after the upcoming four-day Christmas Bank Holiday weekend.  Everyone continues to be asked to think carefully about where is best to go for the help they need. 

Chris Weiner, Chief Medical Officer at NHS Derby and Derbyshire, said: “I am thankful to everyone who has been part of the efforts over the last few days, and also the weeks and months before.  We continue to see more demand than ever before in the NHS, but our collaboration, planning and determination to continue to do the best for our patients has helped immensely.

“Our ongoing concern is that members of the public may be storing up their health conditions until the days after the strikes, or the days following the four-day Christmas Bank Holiday weekend.  This may result in a wave of significant pressure which the services will find very challenging to manage.  This will especially be the case on Wednesday 28^th December when there will be a further ambulance service workers strike and the usual impact of a long Bank Holiday weekend. This may impact on the quality of care we are able to deliver.

“So please access care when you need it, and don’t delay.  For life threatening conditions, continue to call 999 or attend A&E, accepting that waiting times in A&E are upwards of eight hours at present.  For urgent but non-life threatening conditions consider an urgent treatment centre or minor injury unit, where you will be seen much quicker.  For self-limiting conditions, please consider a pharmacy or over-the-counter remedies. If you have concerns about lumps, bumps or unusual pains, then please continue to discuss this with your GP. If you are not sure which service to use, visit NHS 111 online for guidance around your symptoms.”

Further actions for the public

Urgent treatment centres (UTC) can be found in Derby, Ilkeston, Ripley, Darley Dale, Buxton; similar Minor Injury Units (MIU) are available in Lichfield and Tamworth. UTCs/MIUs can help with care for dealing with the most common issues that people attend emergency departments for. Waiting times are always shorter than accident and emergency departments if suffering from things like a burn or a sprain. 

• For other non-urgent cases when you need medical advice, please speak to a pharmacist or visit NHS 111 online.
• Please work with hospital teams to support the discharge of friends and relatives. Having your loved ones’ homes ready, with food in the fridge, the heating on and someone available to meet the transport crew on arrival to help your friends or relative get settled can make a difference to our ability to help get patients home once they are medically fit and to release our transport crews to provide a service for the next patient.
• If you cannot make any NHS appointment, please contact the number on your appointment letter so that it can be reallocated to another patient.
• Please continue to attend for all appointments unless you are contacted and told otherwise.

What we are doing:

Health and care services continue to work together to resolve the situation.  Measures we have taken to help manage and alleviate pressure have included:

• Maximising all available and appropriate hospital capacity to provide beds in which to care for our patients
• Taking additional steps to release patients from the care of ambulance crews to enable them to get back on the road to see the next patient, including extra capacity in ED and extra consultants on hand to assess the clinical needs of patients on arrival, with the aim of turning crews around in no more than 15 minutes from arrival
• Diverting all clinically-trained staff to provide direct care and support, and cancelling all non-essential training
• Opening more than 40 additional community-based beds to support discharge from acute hospitals.

We will continue to prioritise patients in order of clinical need to ensure that we can manage emergency care.  We are working hard to protect planned appointments and operations for patients who have an urgent need or have already waited a long time for their procedure.  Please continue to treat all NHS and care staff with the respect they deserve. Our hard-working staff and volunteers are doing all they can to keep patients safe and supported.