Addenbrooke’s in crisis: Cambridge hospital forced to cancel operations and ‘may have to restrict access to care’
Addenbrooke’s Hospital is being forced to cancel operations daily and may have to restrict access to care amid a crisis it warns is as serious as the height of the first and second waves of the Covid pandemic.
Health chiefs say a lack of beds means it is calling off “the sort of cases we would never imagine cancelling… day after day”.
Staff have been urged to discharge patients where they can in order to free up beds.
There are 900-1,000 beds across Cambridge University Hospitals, but 150 were closed on Tuesday due to infection control and the reconfiguration required due to the pandemic. Today (Thursday), there were 100 closed to new admissions, of which 40 were empty.
Chief executive Roland Sinker said the hospital is at the most “vulnerable” he has witnessed since he joined Cambridge University Hospitals (CUH) NHS Foundation Trust.
The Cambridge Independent exclusively revealed last week how hundreds of staff were off sick due to Covid or other illness. The hospital confirmed that 408 staff were absent due to sickness on October 28, of which 162 absences were Covid-related.
This week, acting chief operating officer Ewen Cameron told staff: “The situation is as serious as it was last year and this is a call to arms to tackle this challenge. Or plan B will mean CUH thinking about restricting access to care.”
And he warned: “Unless we change how we work as an organisation we’re in real trouble.”
The desperate situation comes as Cambridgeshire and Peterborough were designated as an Enhanced Response Area by the government due to high Covid infection rates, with 2,920 cases recorded in the week to October 29, and the highest number of Covid patients in hospital since February.
Mr Cameron said: “Our Covid cases have increased due to several recent outbreaks of Covid across our hospitals.
“Although the number of Covid patients doesn’t seem as striking as before, the impact is much greater as we now also need to provide non-Covid care.
“Our community admission rate is stable, but the increase in Covid within the hospital has had a disruptive impact as we have had to create red capacity and cancel surgery.
“The cases we’re having to cancel due to lack of beds are the sort of cases we would never imagine cancelling, but we’re having to do that day after day at the moment.”
The absence of beds, combined with high demand for services, is creating a perfect storm at the Cambridge hospital.
Mr Cameron added: “The loss of capacity when we’re already under significant pressure has meant we have done very few inpatient elective operations over the past few days. Pressure in ED is also incredibly high again, with lots of attendances.”
“It’s really important that we focus on improving flow through the organisation.”
On Tuesday, all wards were encouraged to try to discharge a patient by 10am and another by noon.
“We know it will be a challenge, but it’s essential that we do this to ensure our patients are safe and so we can get back to operating on some of our very urgent cases that we’ve been having to cancel,” said Mr Cameron.
“We are in a really difficult position at the moment as there are a significant number of beds closed and empty. We have around 900 beds in the organisation. With beds closed due to infection control, on top of those removed due to reconfiguration for Covid and non-Covid patients, we have lost around 150 beds in total.
“That is why our surgical teams have had cases cancelled and colleagues in ED have had to deal with extremely high numbers of patients.
“We hope to get one of the closed wards open again over the next couple of days and assuming we have no further outbreaks, we will get the rest of our capacity open again.
“We weren’t in a great position before these outbreaks and we know that winter is always more difficult, but we have a couple of weeks we really need to get through and then a few months before our additional capacity becomes available.
“If we look at the way things are at the moment, we’re not going to be able to accommodate Covid, emergency, electives, regional specialist and national care with our current way of working.
“The only thing in our gift is what we can do internally.
“We need to change how we work at a time when staff are exhausted and we’re short staffed, which is difficult, but this is where we all need to step up collectively across the whole organisation.
“Relatively small changes across all our wards will get us through this. One discharge this morning across all our wards is 40 beds. Yesterday we managed around 7 in the morning.
“We need to do something different to be able to provide all our services.
“Unless we change how we work as an organisation we’re in real trouble.
“The situation is as serious as it was last year and this is a call to arms to tackle this challenge. Or plan B will mean CUH thinking about restricting access to care.
“This is a signal that the situation is as serious as it was in March 2020 and January 2021.”
Thanking staff for working “flexibly” he reminded them to:
- Wear masks around the hospitals
- Wear the appropriate PPE for the area they are working in
- Practise good hand hygiene
- Carry out regular asymptomatic testing
- Ensure they are fully vaccinated against Covid-19 and flu
Hospital staff have also been told to encourage patients to “wear masks in bed, not just when they are moving about the ward”.
Any patients developing a fever should be tested early for Covid, while there must be regular asymptomatic testing for patients on admission on days three and seven of their stay and then weekly.
“Everyone is doing an incredible job, but we need to rethink the way we provide care as the way we are currently working isn’t enough to get us through to next summer,” said Mr Cameron.
“We’re not alone in this, it’s a national issue, but we have to do all we can to improve the way we provide care.”
Last week, an investigation was launched after a patient died in the back of an ambulance following a handover delay at the hospital.
Meanwhile, the hospital urged staff to take up their Covid booster jabs and flu jabs.
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