NHS beds in the community already occupied ahead of Winter surge

NHS beds in the community – intended to ease pressure on hospitals – are already full across mid and south Essex ahead of the winter season as medics brace themselves for potential surge in COVID cases and flu.

The Mid and South Essex Clinical Commissioning Group joint committee, which funds frontline healthcare, was told of the worrying position as they grapple with a rise in demand with additional concern over staffing.

The NHS trust oversees four wards with 104 beds in community facilities along with 26 stroke support beds and the equivalent of up to 20 “recovery at home beds”.

The committee heard all the beds are currently full of patients being discharged from hospital ahead of the winter season which traditionally sees a rise in demand for hospitals.

A resurgence in COVID is also predicted this winter which could make the situation more acute.

Anthony McKeever, joint accountable officer, said the social care backdrop and staffing were key issues.

He said: “Part of the problem is difficulties in social care and getting domicillary packages. This means patients are flowing into community beds to keep the front door of the hospitals open but another of the pressures people are trying to juggle is staffing.

“It’s not entirely clear to me whether, if we wanted to create more community beds, we would have the staff to do that. As I understand it the only opportunity to increase the number of community beds to facilitate step up would involve shutting down other community services as we did in COVID.”

Karen Wesson, director of commissioning, performance and emergency planning, underlined the seriousness of the situation.

She added: “Because of trying to maintain flow within the hospital the community beds are constantly full so there aren’t ever any empty beds for the urgent community response team to use so that maybe one of the areas of challenge.

“We want to reduce demand and make sure people are cared for closer to home as well.”

Dr Anna Davey, chairman of the joint committee, said the system had worked well in the past, adding: “There are patients who never went into hospital at all and that’s why the step-up beds are important.

“If they are completely full at the moment, and we know we are near the level of activity we are going to see over the next few months, then that begs the question whether we really do have the correct number of community beds open at the moment because we did say a little while ago that we thought we probably did have the correct amount…but if actually the step-up is being hindered because of a lack of capacity then I think we really need to focus on that over the next few weeks.”

The beds are intended to take patients discharged from hospital but who still need some care.

They are also used as step-up beds for GPs and the urgent community response team to refer sick elderly patients who need medical support but not necessarily in hospital.

This was designed take the heat of hospitals and acute services.

Mark Barker, the group’s chief finance officer, said: “We’ve been trying to focus on getting better modelling looking forward to tell us what’s going to happen next. It is more of an art than a science at the moment.

“We’ve got a better appreciation of the risks we have got than we had before. The risk we can’t see coming is the most threatening.”

A spokesperson for Mid and South Essex NHS Foundation Trust, said: “We are always able to care for anyone who needs it, and it’s important that people continue to access the care that they need. We’d encourage people to choose the option most appropriate for them – which could include a pharmacy, a GP, or calling NHS 111 for urgent healthcare advice and help on where to go.”

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Christine Sexton

Local Democracy Reporter