OPERATIONS have been cancelled at Royal Bournemouth Hospital through the winter due to an unprecedented number of emergency admissions, according to managers.
The hospital has opened 40 extra beds this winter, compared with 28 in a typical year, to deal with an influx of patients chiefly suffering from respiratory illnesses and cardiac problems.
Chief operating officer Helen Lingham has arranged a meeting to address the significant risk that there will be more cancellations of surgical appointments and “a lack of timely care” for emergency admissions if solutions are not found.
The hospital has had to cancel up to 15 operations a week at times this winter – prompting a director at a recent board meeting to say the hospital is facing “its worst crisis in a decade”.
Chief executive Tony Spotswood has denied that is the case and blames the problem on a rise in emergency admissions.
He says the hospital is unable to quickly discharge patients for community-based care, which causes a bed blockage. But he denied that bed closures over the past two years had contributed to the problem.
“Over the last six months we have seen higher numbers of emergency patients than the hospital has ever seen before,” he said.
“I think this is because the elderly population is growing, more frail elderly people are living at home, rather than in care, and patients are finding it more difficult to access GPs.
“The problem is compounded by difficulties we have discharging patients who are medically fit, but who may require complex care or placement in a residential care home.
“One problem is the restrictions placed on nursing in residential care homes, as patients with some conditions won’t be admitted.
“Also some need complex packages of community care, and there just isn’t enough support available.
“The PCT and community trust are working to expand these resources.”
The hospital currently has 605 inpatient beds available in total, down from 638 in January last year and 643 in January 2011.
Mr Spotswood said bed numbers were cut due to a year-on-year reduction in the length of time patients are spending in hospital, thanks to improvements in care and organisation.
He added that the reduction in beds had not resulted in any redundancies among clinical staff, and denied that closing them was a mistake, saying it would be wrong to increase capacity for patients who don’t require hospital treatment.
Mr Spotswood said: “The key issue is we have patients looked after by GPs here who would be better cared for in community beds.
“There is a physical limit to the amount of beds a hospital can have, and there are very good clinical reasons why patients should spend as little time here as possible.”
‘Lack of funding’
BOURNEMOUTH councillor Blair Crawford said there is generally a good relationship between the hospital and community care providers, despite the tensions caused by seasonal demand and a general lack of funding.
Cllr Crawford, who is the cabinet member for adult social care, said: “It takes time for a patient to be properly assessed, we can’t have people going in and out of hospital all the time because they didn’t receive the right care.
“The hospital have their priorities, they want to free up beds, and we have put more resources into adult social care to try and speed up the process.
“But we aren’t getting enough Government funding from the Primary Care Trust.
“It is one of the motivations behind the new Health and Wellbeing board, who will be able to identify the funding priorities in the community so money can be better allocated.”
He said the council had joined a group of other local authorities lobbying the government to provide more funding and support for adult social care.
Maternity ward conversion
AMONG the more obvious changes at the hospital in response to the seasonal pressures is the conversion of the maternity ward to provide space for patients with women’s health issues.
The ward has lost six of eight post-natal beds through the measure, which will see women receiving treatment for potentially sensitive health problems looked after next door to new and expectant mothers.
However chief executive Tony Spotswood said there was no chance the two would interact.
He said: “We have two completely separate areas adjacent to each other, one clinical area for women who have had surgery for gynaecological conditions or treatment for breast cancer, the other supports patients receiving pre-natal or post-natal care.”
Chief operating officer Helen Lingham said the hospital was making “hourly and daily decisions” on transferring resources between wards.
Mr Spotswood emphasised that the changes are in response to current pressures and have nothing to do with the Poole merger plans.