For her series Fight on the Frontline ITV News Health Editor Emily Morgan and her team are visiting three different hospitals over three days to focus on the three major issues facing the NHS: staffing shortages, bed capacity and demand.
With the health service declaring itself on a "war footing" as it battles with winter pressures and rising Covid cases amid the Omicron wave, Emily Morgan will speak to those who are fighting on the frontline to find out what it all means for them and those they care for.
The staffing crisis in the NHS is so serious that hospitals are not safe - that is a warning that may not be wildly inaccurate.
Nearly half, 44%, of absences in the last week of December were down to Covid-19 and many hospitals are having to declare critical incidents.
Covid is heaping huge pressure on the NHS, but when the very people who are needed to care for patients are themselves sick or isolating, where does that leave care in this country?
This week, I’m spending time in three hospitals across the country to assess how bad problems caused by Covid are.
Chesterfield Royal Hospital in Derbyshire
Staff shortages in Chesterfield Royal Hospital are biting.
Even before Omicron workers were at a premium, now though, staff absences due to Covid or isolation are at such a level very little in the hospital is operating normally.In Accident and Emergency one nurse told me that between Christmas and New Year, a third of their staff were off on any given day. That, while patient numbers increased.
Charlotte looked tired with it but told me they had a great team and were all pulling together. The problem is the patients don’t stop arriving in A&E, so staff are having to not only treat them but also check on them and ensure they’re happy while they wait for a bed to become free elsewhere in the hospital, which can be for up to 12 hours.
So busy, a whole ward was erected to alleviate pressure on the emergency department.
Sixteen beds were created in the space of 12 hours and staff had to be found to care for the patients. That might sound easy but it hasn’t been. All the nurses assigned to the ward are volunteering to work there. Most have been brought in from education and doctors too have been drafted in from other areas.
There is always much talk from NHS England that bed space is being created, but without the staff to look after the patients in the beds it is a futile operation. Jamie took me round the new medical ward and told me it’s even hard to find staff from the rest of the hospital because many are off sick.
Then there’s surgery. You’d have thought surgery wards in a hospital that’s postponed elective/planned operations would be quieter, well you couldn’t be more wrong.
Emergency surgery is still going on and the matron is on her knees. Over Christmas there were so many patients and so few staff she didn’t think they would manage all the patients.
Of course they did, but her job juggling patients and asking staff to do extra shifts and cover colleagues was extremely difficult. The number of patients, she thinks, has increased because so many of them are on waiting lists their ailments are getting so bad they end up in hospital having emergency treatment. Pausing planned operations again is just going to exacerbate the problem.
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Despite what I have seen and heard at Chesterfield Hospital I left with a sense of optimism.
The conditions staff are working under are undeniably stressful and pressurised but the wit and wisdom with which they solve problems and is enviable. There have been warnings that pressures on the service could mean care is compromised and, yes, many of the staff agree it might not be quite what they’d like but they are doing everything humanly possible to try to ensure it is.
The NHS is struggling to cope but the staff I met today are not letting anything beat them. That can only be admired.
I am often in hospitals, usually focusing on patients and how Covid is directly affecting them and staff; what I am not used to is focusing on staffing numbers and whether they are contributing to a drop in the level of care.
Royal Bournemouth Hospital
For every Covid patient that ends up here, many other people who need planned operations then can’t have a bed here. And demand in A&E is even greater.
Bruce Hopkins, Emergency Department Matron, said slower ambulance times are having a knock-on impact.
“A lot of patients are kind of voting with their feet because there is such long waits for ambulances, so they are walking in with illnesses that they would have otherwise presented via ambulance,” he said.
“We just kind of have a bit of a medical ‘Where’s Wally?’ where we try to find the sickest patient in a crowded waiting room.
“Because those chest pains and abdominal pains are also being mixed with patients who should have really gone to the GP."
Those unable to leave hospital are clogging up the system so hospitals can’t get other patients into wards - this is one of the major issues facing the health service at the moment.
I have been asking all week what the answer is. Most people I ask, simply shrug their shoulders and say they don’t know.
The medical commander in Bournemouth did have one answer, they are taking over hotels to transfer patients into. It begs the question: how long can that go on for?
The long term solution is to get patients back home and care for them there, which is exactly what Portsmouth rapid response team does.
The unit is made up of health and social care professionals, from nurses to physiotherapists and paramedics. Their job is to respond to callouts in the community, help care for patients with chronic illnesses at home and ensure patients can be discharged from hospital safely.