Scores of patients in hospitals in Bristol and Weston-super-Mare are medically fit but cannot be discharged due to a shortage of community carers.
Hospital boss Robert Woolley said: “We’ve got 5% of beds occupied by Covid-infected patients. Crucially, we’ve got about 20% of our beds occupied by patients who are medically fit for discharge. They don’t need to still be in a hospital bed.”
The University Hospitals Bristol and Weston Trust declared an internal critical incident throughout October, with unprecedented demand for urgent care and the poor flow out of hospital continuing to affect performance.
More than half of all ambulance handovers were delayed by more than 30 minutes – worse than at any other time during the pandemic – and almost 600 patients waited on trolleys for more than 12 hours before they were treated.
At the end of October some 187 patients had been waiting more than two years for treatment, although most were lower clinical priority and deemed safer to wait longer.
Woolley apologised for the resulting delays and cancellations and appealed for the public to play its part by accessing care wisely.
Updating the hospital trust board on 30 November, Woolley said: “Our A&E department is at pre-pandemic levels but we’re finding that patients are presenting later than they would have done so their conditions are potentially more serious and complex, and our capacity is severely constrained.”
At the end of October there were 97 patients medically fit for discharge in the trust’s Bristol hospitals and 48 at Weston General.
“This is creating significant delays for patients trying to come into hospital, it’s creating cancellations,” Wooley added.
“The reason our beds are occupied in the way they are is largely because of workforce shortages in the community and social care.
Bristol’s head of adult social care, Stephen Beet, said in October that staff shortages in social care were the worst they have ever been, which were leaving some care homes and home care providers struggling to provide care.
“The end of lockdown means that other services are offering work,” Beet said. “So we’ve got much greater competition from places like Amazon and big supermarkets where pay is better, or there’s greater incentive.”
“Brexit’s another factor. And generally just poor pay and lack of development opportunities perceived in the care sector that’s not drawing people into it. And it’s hard work. These are tough jobs.
Wooley said he expected the winter to be a difficult one, as it always is. “We’re facing the unknown impact of Covid this winter, particularly in light of the new Omicron variant. We don’t know how influenza is going to play out.
“Our ask of the general public is to continue to access the care you need but do so wisely, make use of NHS 111, only use emergency departments for serious injury or illness. We ask for your understanding about the delays and the pressures on our staff.”