A 'perfect storm' of patient demand puts Royal Bolton Hospital under extreme pressure
Report by Granada Reports journalist Claire Hannah
Patients are being cared for in the corridors of one of the region's biggest hospitals as medics warn it is under extreme pressure.
Staff at the Royal Bolton say the large numbers of seriously ill people coming through the hospital's doors mean there are limited numbers of beds for those who need them.
The numbers of beds taken up by patients fit to be discharged is 25% higher than the start of December 2021.
And, across the country there was a dramatic rise in the number of people admitted to hospital with flu or norovirus.
The Royal Bolton sees 400 patients a day at A&E department. In 2018 capacity at the emergency department was increased so they could deal with 90,00 patients a year.
In 2021 the department dealt with 138,000 patients, with the number likely to be exceeded this year.
Divisional Medical Director for Acute Adult Care, Rauf Munshi, says: "I think the whole health service is struggling and often A&E is seen as a barometer for what the health service is like.
"So when A&E is busy that tells you the whole health service is struggling. Demand is massive at the moment.
"Primary Care is struggling to keep up with demand. We have issues in social care so we have patients stuck in hospital we can't discharge.
"We're seeing a lot of really unwell patients who may not have had access to health care over the last three years.
"They may not have seen their specialist regularly for a chronic condition and are now coming into hospital acutely unwell.
"We are also seeing an increase in flu so we are seeing an increase in flu cases being admitted to hospital."
ITV Granada was given exclusive access to the A&E ward at the Royal Bolton Hospital on Friday 2 December.
On our arrival, the corridor was full of trolleys, each with a patient on.
This is because, simply put, there is a shortage of beds.
A screen shows where beds are available across the whole hospital, and more crucially, where they aren't.
It is graded in a system similar to traffic lights, with black being the worst state it can be.
When we were there, the children's ward was black.
This is just a snapshot though, it changed throughout the day as the bed management team goes on rounds around the hospital, checking which patients can be moved, or sent home.
But, in some cases there are people who are fit enough to be discharged but due to problems in social care, there is nowhere for them to go.
The Royal Bolton Hospital is keen to stress they would never turn a child away, or any patient if they needed their care, adding the 'black status' on the children's ward is completely expected for the time of the year.
Bolton NHS Foundation Trust said "We manage our children’s beds in exactly the same way we would with adults.
"That’s by working to identify patients that are ready for discharge to free up capacity. It involves additional ward rounds to recover that capacity and ensure safety."
Imran Khan, the Urgent Care Lead, said problems discharging patients, coupled with more and more coming to A&E, mean it is getting busier and busier.
"There's a perfect storm," he said. "We've had the pandemic, we've got an older population.
"That population have not just one medical condition, they might have a multitude of conditions which means they'll take longer to treat in the emergency department but they may stay longer on our wards.
"Couple that with the problems that we've got in terms of discharging patients from hospital and that means the length of stay has gone up and it puts pressure on the emergency department.
"We've seen a difference in the way people access health care.
"People have chosen to come to A&E where other alternatives might have existed, for example general practice or pharmacies. "
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