A&Es struggle after 'sharp rise' in demand

A sharp rise in demand in A&E units is causing real problems for hospitals, NHS bosses are warning. The BBC has learnt some NHS trusts have even had to take extreme measures to cope with the exceptional pressures. One hospital had to cancel all its routine operations, while another considered setting up a temporary treatment area in a tent.

Over the past fortnight there have been 45 temporary closures of A&E units up 50% on the same period last year. This is considered an extreme step in which ambulances are sent to other hospitals and is ordered when wards are full and waiting times increasing rapidly. The number of patients visiting A&Es in England jumped by 20,000 last week to nearly 340,000 well above the average for winter.

As well as a rise in visits to A&E, hospitals bosses are also reporting problems discharging patients. NHS England warned the pressures would last to the spring. Among the problems reported were:

  • Coventry University Hospital cancelling all its routine operations on Wednesday and for part of Thursday because of exceptional circumstances.
  • GPs in north London being told to try to avoid referring patients to emergency departments in Ealing and Northwick Park because of very high pressure
  • A double-sized ambulance having to be parked outside Leicester General Infirmary last weekend as A&E staff were struggling to cope with the numbers of patients being brought in. Bosses even discussed setting up a temporary treatment area in a tent.
  • Royal Cornwall Hospital spending a week on black alert a sign of extreme pressure which led to routine operations being cancelled each day to free up resources. The black alert status was lifted only on Thursday.
  • Portsmouth Hospitals NHS Trust also spending time on black alert this week after exceptional numbers of very sick, frail and elderly patients needed care.
  • Last weekend NHS 111 seeing a huge rise in calls up by more than a quarter on the same weekend the year before
  • A snapshot poll of major UK A&E units by the Royal College of Emergency Medicine suggesting during the first three weeks of January between 80% to 85% of patients were seen in four hours well below the 95% target

Special report page:1 For the latest news, analysis and video

Winter across the UK:2 A guide to how the NHS is coping

Video:3 Why hospitals are under so much pressure

Video:4 How a hospital can grind to a halt

Coventry University Hospital s chief executive, Andy Hardy, said this week had been incredibly difficult .

I would like to apologise to any patients who have been affected.

The pressures built during Tuesday when more than 500 patients turned up at A&E, leading to the unprecedented step of cancelling all the routine operations, such as knee and hip replacements, that had been planned for Wednesday and Thursday. Mr Hardy said the trust had large numbers of patients in the hospital who did not need to be there but could not be discharged because there were no spaces in the community. Leicester s clinical director for emergency medicine Dr Ian Lawrence said the numbers coming in had rocketed since the start of January.

Almost every bed in our three hospitals is being used and many staff members have voluntarily done extra shifts to help out, he added.

Dr Cliff Mann, president of the Royal College of Emergency Medicine, said the NHS was reaching a critical point in winter.

We were beginning to think this winter would not be as bad as last winter, but the problems we are beginning to see suggest it could end up being worse.

We have virtually no flu or norovirus a vomiting bug which leads to mass ward closures if there was to be an outbreak of either we could see the whole system tip over. NHS England s Richard Barker said the recent bad weather was likely to have contributed to the sharp rise in A&E visits.

The pressures remain very real. We don t expect those to abate in the run-up to spring, he added.

Elsewhere in the UK significant problems have been reported last week doctors in Wales warned A&E was on the edge .5

Source By: BBC


  1. ^ Special report page: (
  2. ^ Winter across the UK: (
  3. ^ Video: (
  4. ^ Video: (
  5. ^ on the edge . (

BBC may ask over-75s to give up free TV licence

People over 75 may be asked to give up their free TV licence or make a voluntary contribution to it, under plans being considered by the BBC. The corporation is due to take on the 650m cost of free licences for the over-75s from 2020 as part of a funding deal agreed with ministers last year.1

A report on ways to appeal for voluntary contributions is due in 2016. The BBC has refused to comment on suggestions that older celebrities might front a publicity campaign.

The Times reported that2 such a campaign could be run by personalities such as Sir Michael Parkinson and actress Dame Helen Mirren.

The BBC confirmed a consultancy business led by Lord O Donnell the former cabinet secretary would report back within months on the best approach to asking people for contributions. The corporation s payment of TV licences for the over 75s will be phased in from 2018-19. In return, rules on paying for catch-up services such as iPlayer might be introduced and the licence fee will rise with inflation.

Funding free licence fees for over-75s cost the government 608m in 2013-14 about a fifth of the BBC s budget.

In a statement made at the time of the announcement in July, the BBC said it was the right deal in difficult economic circumstances .

  • BBC One s budget 1bn
  • Radio Four s budget 91m
  • Cost of free licence fees for over-75s 608m


* 271.4m of the total used by the Government to fund S4C, the local TV scheme and broadband rollout.

Source By: BBC


  1. ^ as part of a funding deal agreed with ministers last year. (
  2. ^ The Times reported that (