Winter pressure forces NHS to halt elective care until end of January

NHS hospitals have been told to extend the deferral of all non-urgent inpatient elective care until 31 January to free up capacity for the 'sickest patients' as winter pressures affect services into the new year.

NHS hospital (Photo: iStock)
NHS hospital (Photo: iStock)

Cancer operations and time-critical procedures will continue as normal, but all non-urgent inpatient elective care will be halted, while day-case procedures and routine outpatients appointments will also be stopped 'where this will release clinical time for non-elective care', following advice from NHS England.

The move is likely to see tens of thousands of operations pushed back and could add to already severe pressure on primary care services.

Official data published on 29 December reveal that the proportion of hospital beds occupied across England fell from 95% in the week ending 17 December to 90.9% in the week ending 24 December.

Winter pressure

The drop came as hospitals began to implement NHS England advice issued in mid December that 'inpatient elective care should be deferred until mid-January to ensure beds and staff are available for the sickest patients'.

NHS England's national emergency pressures panel has now advised hospitals that the deferral of elective care should be extended until at least the end of January, noting that the NHS had faced 'sustained pressure over the Christmas period with high levels of respiratory illness, bed occupancy levels giving limited capacity to deal with demand surges, early indications of increasing flu prevalence and some reports suggesting a rise in the severity of illness among patients arriving at A&Es'.

GPonline reported exclusively in December that practices had been ordered to reduce referrals to hospitals and patients had been diverted back to GPs from A&E, after winter began with more than 100 hospitals already reporting more than 90% of their beds were full.

GPC chair Dr Richard Vautrey said: ‘With limited resources and rising demand it’s the right thing to prioritise the sickest but this is yet another sign of how much pressure the NHS is under. It’ll also mean that GPs will not only have to cope with the rise in seasonal illness impacting their patients but will now also have to manage patients waiting longer and longer for procedures they need.‘

Time freed up by delays to routine care should allow hospitals to 'implement consultant triage at the front door', so that patients arriving in A&E departments are seen quickly by senior doctors, NHS England advice says.

Telephone advice

GPs should also have greater access to telephone advice from consultants, additional inpatient beds should be set up, and patients should be reviewed twice a day in hospital to 'facilitate discharge'.

CCGs have also been advised to suspend penalties for hospitals that breach requirements around mixed-sex hospital wards.

Emergency pressures panel chair Professor Sir Bruce Keogh said: 'I want to thank NHS staff who have worked incredibly hard under sustained pressure to take care of patients over the Christmas. We expect these pressures to continue and there are early signs of increased flu prevalence.

'The NHS needs to take further action to increase capacity and minimise disruptive last minute cancellations. That is why we are making these further recommendations today.'

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