‘Dramatic’ increase in demand sees Sheffield A&E targets missed for fifth successive month

Sheffield's Northern General Hospital, in Fir Vale.
Sheffield's Northern General Hospital, in Fir Vale.
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More than 13,000 people flooded A&E in Sheffield in one month – as demand on urgent care services ‘dramatically’ increases.

The figure meant waiting time targets were missed in Sheffield for the fifth month in a row. ‘Crowding’ in A&E at the Northern General Hospital for treatment in March was blamed as one reason it took too long to see many patients. Compared to March 2014, the hospital dealt with an extra 400 patients in A&E, with 300 extra patients being brought in by ambulance.

A total of 92.3 per cent of patients were seen within four hours during the month – below the national target of 95 per cent. The last time the target was successfully hit in Sheffield was in October 2014. The new figures are to be discussed by Sheffield Teaching Hospital NHS Foundation Trust’s board of directors on Wednesday.

A report to the board said the trust has faced an ‘extremely challenging’ time.

It said: “The percentage of patients which take more than four hours from arrival to admission or discharge has significantly increased since October 2014.”

“The delay in managing patients through the department can be linked to crowding, high numbers of attendances, high numbers of ambulance arrivals and shortages in clinical capacity.”

The report comes as the initial findings of a major review into urgent care services in Sheffield said the ‘increase in demand far outstrips what we could put down as a result of an ageing population’.

The review said there is a ‘strong association’ between the use of such services and people living in poorer areas of the city.

Work is continuing to establish the reasons behind the rise, as part of an attempt to make urgent care services in the city more efficient.

The review was ordered following ‘unprecedented demand’ on city A&E services this winter.

It is examining all urgent care services in the city, including A&E units, the walk-in centre on Broad Lane and GP out-of-hours services.

Ideas being looked at include the possibility of urgent care services sharing buildings and integrating their work more closely.
It followed figures showing more than one in 10 patients who go to A&E in Sheffield do not need to be treated there.

The initial findings of the report were presented to Sheffield Clinical Commissioning Group’s governing body.

Report co-authors Alastair Mew, head of urgent care commissioning, and Dr St John Livesey, clinical director for the urgent care portfolio, said: “The initial findings show demand has gone up dramatically across all aspects of urgent care – not just A&E, but also ambulance services, emergency calls and GP consultations

“This increase in demand far outstrips what we could put down as a result of an ‘ageing population’. The majority of this increased utilisation of urgent care is for less severe presentations/minor illnesses.”

Kirsten Major, Sheffield Teaching Hospitals strategy and operations director, said: “We are routinely seeing nine out of 10 patients within four hours of their arrival at A&E, which is thanks to the hard work of our staff.

“We have narrowly missed the national standard of 95 per cent in April, but this is predominantly because the increased demand we saw throughout winter has continued.

“Compared with last March for example, we saw almost 500 more patients in A&E and an additional 300 patients needed to be admitted for emergency care.

“We are currently reviewing how we provide emergency care within the hospital but also in partnership with Sheffield CCG and primary care to see where we can make changes which will enable us to manage this continual increase in demand and routinely meet the four-hour standard. We are currently on track to meet the standard for May.”