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Broomfield at breaking point: Why was the Chelmsford hospital's A&E department so stretched?

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BROOMFIELD Hospital's accident and emergency department was stretched to breaking point on Friday, with ambulances lining up outside and elective surgeries cancelled due to the number of patients.

But hospital chiefs said Friday's situation was not out of the ordinary, and that the casualty department had suffered from similar problems at least once a day over the past two weeks.

In the past few months, accident and emergency has seen an increase of patients of 27 per cent, with many of them not requiring any urgent medical treatment, according to the hospital's medical director, Dr Ronan Fenton.

The overcrowding has left Broomfield urging patients to seek alternatives to A&E, such as 111, GP surgeries or walk-in centres, where possible.

"In 2013, a busy day in casualty would be 220 people, with about 50 ambulances," said Dr Fenton.

"Over the past few months, we are seeing 280 people in A&E and about 80 to 90 ambulances.

"That is a quantum shift in people coming through the doors. It's not cold, we haven't seen an increase in one or two particular illnesses, but what we have is an increase of seven to 10 per cent in people coming to A&E.

"We have a conversion of about 30 per cent coming in to hospital from A&E, which means hospital beds become full with people who weren't necessarily expected to be there.

"That impacts on elective surgery, so for example an elective hernia operation will need to be re-scheduled.

"We will always do emergency operations, but the increase in numbers does have a knock-on effect on elective operations."

On just one day over the past few months, 33 patients had their elective operations cancelled at Broomfield, while Dr Fenton said that in around 12 per cent of cases the four-hour turnaround time for patients to be seen, investigated and treated was being breached.

According to recent figures from the British Medical Association, Broomfield Hospital is not alone, with hospitals up and down the country experiencing a similar rise in patients visiting casualty departments.

Dr Paul Flynn, consultant committee chairman from the BMA, suggested chronic underfunding was contributing to the problem.

He said: "Despite frontline staff working as hard as possible to meet the rising demand, pressure on the NHS is continuing to increase, with the latest figures showing a significant rise in the number of patients visiting A&E, and a substantial drop in the number of patients being seen within four hours," he said.

"Last week there were over 110,000 emergency admissions to hospital, one of the highest since records began, and nearly 30,000 more patients visited A&E compared with this time last year, but only 91.8 per cent of patients were seen within four hours, significantly below the target of 95 per cent and down on figures from this time last year, of 94.8 per cent.

"This is the result of years of underfunding, and will not be turned around overnight, despite politicians' promises to commit additional money to the NHS or the recent announcement of £300m to alleviate winter pressures, which is in fact money taken from other over-stretched services and falls far short of what's needed."

Other hospitals in Essex are also feeling the pressure, with Colchester General last month declaring a "major incident" and only patients with life-threatening illnesses were accepted into A&E, although the casualty department has reported a decline in patients since returning to normal, with its adjacent walk-in centre reporting an increase in numbers.

But while Colchester's walk-in centre has alleviated the pressure from its casualty department, Springfield's walk-in centre is set to close for good in March, prompting fears from local residents that Broomfield A&E will be under even more strain.

But Dr Fenton said since Springfield's walk-in centre had not acted as a deterrent for people going to A&E, he did not expect its closure to bring about a sizeable increase in patients seeking treatment at Broomfield.

He saidd: "We are working with GP colleagues to provide more GP services here on site, which will almost act as a filter for A&E and take the pressure off us, because patients requiring non-urgent treatment will be able to go next door to the walk-in centre.

"With Springfield's walk-in centre closing in March, it could well create an increased footfall here, but we will anticipate that, and the plans are that we are looking at what will transfer to us and we plan to have a facility here."

However, despite plans to develop more walk-in centres, Dr Fenton explained that people's attitudes to using casualty departments needed to change more than anything.

He said. "If another 100 people came through the door, we would see them and keep them safe. But people need to see themselves as part of the system.

"If they don't need urgent medical treatment, there are places they can go for help other than A&E."

Broomfield at breaking point: Why was the Chelmsford hospital's A&E department so stretched?


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