Hospital trust sees more than 9,400 12-hour trolley breaches in a year

The number of breaches more than doubled from 2021/22, when there were 3,854 incidents of A&E patients waiting more than 12 hours for a bed, to 9,428, University Hospitals of North Midlands (UHNM) NHS Trust’s annual report said.

UHNM which runs Royal Stoke and Stafford’s County Hospital, also saw the percentage of patients waiting less than four hours in A&E fall during 2022/23 to 63.5 per cent, down from 66.9 per cent the previous year. The national target is for 76 per cent of patients to be admitted, transferred or discharged within four hours of arrival at A&E – and UHNM’s target for 12-hour trolley breaches is zero.

During the latest winter period, hospital emergency departments across the country faced unprecedented demand for services, the annual report said. It was described as “the worst winter ever in the NHS” and “saw ambulance waits reach crisis point”.

The report added: “During 2022/23, attendances at the emergency department were in excess of 162,000, having an impact on the number of ambulance handovers transacting in a timely manner, patients seen within four hours and those waiting over 12 hours for admission into the hospital. To mitigate these delays and improve patient experience, numerous initiatives have focussed on improving flow through the hospital, the most significant of which include Front Door Reconfiguration (to ensure sufficient physical space to appropriately handover and treat patients in the emergency department) and the implementation of the Referral and Admission Policy (to ensure timely specialty input in the most appropriate environment where such expertise is required) .

“Our teams of clinicians and support staff worked heroically in dealing with the issue and the introduction of a new initiative, Your Next Patient, improved safety for patients, released ambulances from queues and focussed our partners in the wider community and system to collaborate in new ways for the benefit of our population. In addition, we opened our new Enhanced Primary Care facility, which helped significantly in redirecting patients to a more appropriate setting, and we invested heavily in strengthening the emergency department nursing and junior doctor workforce.”

Improvements made to the emergency department led to the Care Quality Commission (CQC) removing a condition this summer that it had imposed on UHNM following an inspection in 2019. The trust is also aiming to improve its performance against the A&E four-hour waiting time target – in April this year the percentage reached 70.1 per cent, and was 68.8 per cent in July.

But demand for services in 2023 led to temporary winter beds still being in use this spring and 12-hour trolley waits soaring compared to previous months. In May there were 665 12-hour trolley waits, compared to 286 in April.

Speaking at the trust’s annual meeting on Wednesday, UHNM Unison branch secretary Stewart Robinson asked hospital bosses: “What confidence have the staff or public got in what you are saying is going to happen? Some of the figures, like A&E waits and 12-hour waits, have been there for several years.”

UHNM chief executive Tracy Bullock responded: “We need to look at the improvements we have made – we have never had ambulance waits reduce like they have and our four-hour performance has never been at the rate it is now. It’s still not high enough, but it is improving.

“Our 12-hour waits are reducing quite significantly. When I joined the trust four years ago our performance was really poor.

“We are the most improved trust in the country in relation to four-hour performance. That doesn’t mean to say we are where we need to be, but to be the most improved trust tells us we are going in the right direction.

“I think we are seeing some of the improvements we want to see. We have the building blocks in place and we need to sustain it.”