Queen Alexandra Hospital in Portsmouth so busy A&E doctor says it's 'worst' he's seen in 25 years
SENIOR medics at Queen Alexandra Hospital have lifted the lid on relentless pressure pushing them to the brink.
Leaders and frontline staff have said Covid patients, people with seasonal respiratory illnesses and very sick patients pouring into A&E are leaving exhausted workers battling what could be the ‘worst’ winter period.
QA’s top doctor and nurse are imploring the public through The News to do all they can to protect the hospital.
Their requests are simple: take up the Covid vaccinations on offer including a booster, get your flu jab if eligible, wear a mask, and pick the right place to get the care you need.
So intense is the pressure put on QA Hospital – with the rest of the NHS in the area also under strain – that each morning just a ‘handful of beds’ are unoccupied.
Intensive care capacity has been increased to cope and a new emergency care centre has opened to treat patients not needing a bed away from A&E.
Emergency medicine consultant Dr Chris Busutill spoke to The News while leading an A&E caring for 100 patients.
He said: ‘In the 25 years I’ve been a doctor this is probably the worst I’ve seen just in terms of “busyness” - the whole department.
‘It’s been like that for the best part of two and a half years... it’s physically and mentally tough.’
He added: ‘People are coming up to us who potentially could be looked after in different ways. The ones that are sick are incredibly sick.
‘Covid is not helping but Portsmouth unfortunately - its general health is not as good as it could be and people have long-term conditions.
‘I think the biggest message is we’re not trying to be difficult at the front door - we’re trying to prioritise the people we need to see.
‘I know how frustrating it is for them, it’s equally frustrating for us - it’s not being difficult or trying to make people feel unwanted.’
He said when people see pictures of queuing ambulances they should know the entire A&E team inside is ‘doing absolutely everything’ to see patients.
On Thursday, when The News was at QA Hospital, there were 80 patients with Covid. There were also seven in critical care and 10 requiring additional care.
Last week saw the number of new Covid cases in the community in Portsmouth vary between 125 to 183 each day.
Medical director Dr John Knighton said he is worried demand may still outstrip capacity - a concern also raised in the summer.
‘Our whole occupancy is running very close to 100 per cent,’ he said. ‘We are operating absolutely at the margins of capacity to meet the demand.’
It comes after ‘one of the busiest summers we’ve ever had in the NHS’ and QA Hospital is looking to increase beds, he said.
His teams are working to treat and discharge patients on the same day - if possible - so people are recuperating out of hospital, and this frees up beds.
Medical beds have been increased so it stands at 115 per cent of its normal capacity.
Around 20 per cent of arrivals at A&E are going through the new emergency care centre - and this is helping the pressure.
On his concerns, Dr Knighton said: ‘One is that if we see a significant increase in demand for the hospital services beyond what we’re already managing that may push us beyond our ability to meet some of that.
‘Secondly it’s around the ongoing pressures on our workforce individually and collectively - it has been an incredibly intense nearly two years now and there hasn’t really been a chance for recovery or recuperation.
‘No matter how professional and committed our workforce are - and they genuinely are - it takes a toll.
‘And I'm worried about the personal impact on individuals.
‘I'm worried about the impact that might have with people staying in the NHS over a long period.’
The hospital is still battling a backlog of treatment from lockdowns, with some 47,000 people on waiting lists for various treatment, according to latest NHS figures.
Dr Knighton said: ‘Working at the intensity that we are doing, even the marginal additional waste of time is important and every time that someone doesn’t turn up for an appointment is a wasted opportunity for someone else to be treated.
‘That’s very uncomfortable for our staff.’
A key focus is making sure patients are not at the hospital for any longer than they need.
Chief nurse Liz Rix said: ‘We are working together to expedite discharge because the safest place for a person to be is their normally place of residence, especially when we’re talking about infection risk.’
‘There will always be patients waiting and we will have a number of those. But that is significantly lower than it has been in the past.’
:: NHS leaders reveal pressure on public health, GPs and ambulance service – see The News later this week.
Staff ‘are tired’ but still work flat out
STAFF have been working flat out throughout the pandemic, the city hospital’s chief nurse has said.
Queen Alexandra Hospital’s Liz Rix said she was ‘really proud’ of how everyone works together.
She said: ‘Our nurses, our nursing support workers and our allied health professionals, who are physios, and our OTs.
‘They're the ones that are on the wards all the time. They're the ones that are caring for patients, helping people to support them to recovery and eventually, discharge and that is constant - that's 365 days a year, 24 hours a day. So it's hard at times.’
She added: ‘People are tired but it never ceases to amaze me how our staff support each other.
‘What we have to make sure is that we can wrap services around them to help them when they need it. We've got some great facilities here
The top nurse added she knows it’s ‘undoubtedly hard’ for families of patients in navigating visits.
But she said the goodwill seen for the NHS in the early days of the pandemic needs to be directed at now protecting the hospital.
She said: ‘The goodwill is still there. I think we need to use that goodwill in a different way. And that is please work with us, help us to protect our patients and yourselves.
‘We're not saying you can't come and visit because we want to, we're saying we need to do this safely.
‘We do have patients with Covid. We have patients who would be vulnerable if they caught Covid.
‘If you're out in the community, with the best will in the world unless you’ve done a lateral flow test, you don't know whether you could cause harm or not.’
She added: ‘So if you need to come to hospital, you absolutely need to come to hospital, we only will always see you.
‘But think about other services available from a diversity perspective, like 111. That's what our public can do for us now.’
Patients without Covid vaccine are ‘getting seriously ill’
MOST Covid patients in Queen Alexandra Hospital are those who have not been vaccinated.
Medical director Dr John Knighton said those without a jab are getting seriously unwell.
He said: ‘There is, as always, a mix but it is definitely true to say that the majority of patients coming in with Covid - and particularly the majority of patients who are getting seriously ill with Covid - are not fully vaccinated
‘And in many cases they’ve had no vaccine at all or haven’t yet completely a full vaccination course.
‘So if there’s one thing that everyone can do - it is to ensure that they take the offer of vaccination as early as possible, or if they have any questions or concerns about it, to talk about those with a healthcare professional.’
He said there is a ‘small proportion’ of people aware of the benefits who have declined it, but there is a ‘section of the population’ who are unsure or concerned about potential risks with vaccination.
‘Almost all of those risks are either overstated or actually misleading,’ he added.