Walsall Manor: Hundreds wait over four hours in A&E

Performance has plummeted again at the hospital following a spike in patient numbers through the doors.

Emergency attendances jumped by 593 visitors to 10,665 from June to July.

Out of those, 1,519 waited more than the national benchmark of four hours to be treated, discharged or admitted.

It means the trust's performance has slumped to 85.8 per cent of people dealt with in time – its lowest since March.

The NHS standard sets the bar at 95 per cent.

It comes after it emerged last week that the Manor could see dozens of extra children in the A&E department over the coming weeks due to the closure of the emergency centre for under 18s at Stafford for safety reasons.

Walsall Healthcare NHS Trust has stated the warm weather has contributed to growing demand.

Steven Vaughan, interim Chief Operating Officer, said: "July was a little busier than previous months and as part of our continual review of activity we will see if there any specific issues that account for this.

"We had a period of hot weather which may have had some effect but there is often a combination of factors, rather than a single issue, that contributes towards such an increase."

There were 12 days during July when more than 90 ambulances arrived at the Manor Hospital.

On four days more than 100 descended on the site.

A report which went to the governing body yesterday also stated that a lack of beds had contributed to long waits for patients.

It said: "Performance in July was 85.76 per cent, which is a decline compared to June 89.59 per cent.

"During July, the highest number of breaches that occurred for four-hour waits were due to unavailable beds when required in the Division of Medicine (mainly beds within Acute Medical Unit)."

The same papers also revealed that recruitment plans were in place which included employing a 'capacity manager' to handle patient flow.

In recent weeks the trust's 'System Resilience Group' has been given the latest national guidelines surrounding emergency care.

The national focus is on five key areas.

The first aim is to improve patient streaming at the front door in order to allow staff in the main department to focus on people with more complex conditions.

The second objective is to increase the number of NHS 111 calls transferred for 'clinical advice'. This will hopefully reduce calls to ambulances and consequently visits to A&E.

Another aim is to focus around ambulances, to increase more patients treated at the scene or at home rather than being taken to A&E.

While a priority area is to improve patient flow by reducing the inpatients length of stay to make more beds available.

The final area of focus is around the discharging of patients which will 'point to home' as the first port of call providing it is clinically appropriate. The Walsall trust has not met the four-hour 95 per cent target since May 2015.

Performance this year peaked at 92 per cent in May but has dropped during the traditionally busier summer months.

The trust's original trajectory was to hit the benchmark by October but that now looks unlikely given the latest figures.

A&E was one of the Manor Hospital's major failings when the Care Quality Commission visited in September and placed the trust in special measures in February.

Emergency services were branded 'inadequate', which along with maternity services led to the trust receiving an 'inadequate' rating overall.

The CQC declared the trust's problems meeting national emergency targets have dated back for at least two years.

Its report said: "The percentage of patients seen within the national four hour target to see, treat and admit or discharge 95 per cent, was worse than the standard or national average for almost all of the period between April 2014 and May 2015.

"We saw the percentage of emergency hospital admissions waiting four to twelve hours from the decision to admit until

being admitted (18 to 50%) was consistently above the England average of 5 to 15% between April 2014 and April 2015.

"Staff were caring and compassionate towards patients and their relatives. We did however see that in both ED and Maternity the excessive workload led to the standards of caring falling below that we would expect."