Unnecessary walk in patients driving pressure at QA hospital

Portsmouth City Council’s health overview scrutiny panel met today with local NHS executives to discuss ongoing pressures at QA Hospital.

Overall bed occupancy at the Cosham hospital averages around 127.9 per cent.

On an average day, around 256 beds are taken up by patients who have no criteria to reside (NCTR) in hospital but are awaiting transfer to their next place of care.

In January this year, 72.7 per cent of patients were admitted, discharged or transferred within four hours and 17 per cent experienced waits of over 12 hours.

Additionally, there were 10,000 more attendances than planned for that time of year.

The hospital’s urgent primary and emergency care centre sees around 134 patients per day, according to Simon Barson, COO of Portsmouth Hospitals University NHS Trust, which manages QA.

This accounts for half of hospital walk ins, aiming to relieve pressure on the hospital emergency department (ED).

Mr Barson added that of those 134 patients, only 7 per cent result in admissions, and the cases that do are largely bone fractures.

Overall, “40 per cent of walk ins are primary care in nature”.

In response to a question from Cllr Suzy Horton on the 10,000 spike in patients in January, he noted that the spike does not correlate with ambulance demand or admission numbers, adding: “the numbers we’re seeing is a genuine walk in pressure point”.

In response to a question by Cllr Mark Jeffery, he clarified that the NCTR patients make up nearly a quarter of QA’s 1033 beds, which is high compared locally and nationally.

He added that NCTR patients are predominantly elderly.

Hampshire county councillor Lesley Meenaghan asked about patients going to ED who “should’ve gone to their GP” and asked whether the hospital is asking patients, respectfully, why they are in ED unnecessarily.

In response, Mr Barson said it is “difficult” to garner the answer from patients, but it usually stems from being unable to get an appointment.

However, “when you probe at that it’s not necessarily always clear that it was about the appointment”, with some stating they tried but did not get through to their GP or did not wait for a call back.

James Lowell, chief delivery officer at the Hampshire and Isle of Wight Integrated Care Board, described patients accessing care in the wrong setting as a national issue and encouraged the use of online consultations and pharmacy first.

“The more we collectively do to message the public of different ways of accessing, we’ve got a better chance of changing people’s behaviours but this is really a concerted effort that will take a number of years.”