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‘Challenging and complex time ahead’ at Addenbrooke’s Hospital in Cambridge

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Cambridge hospitals are facing a “challenging and complex” time, with a tired workforce and a “system under pressure”, say health chiefs.

Addenbrooke's Hospital Picture: Keith Heppell (53013108)
Addenbrooke's Hospital Picture: Keith Heppell (53013108)

The challenges being faced were raised at a Cambridge University Hospitals NHS Foundation Trust board directors’ meeting yesterday (Wednesday, November 10).

Dr Mike More, chair of CUH, which runs Addenbrooke’s Hospital and The Rosie, said the trust is entering a third phase of its pandemic response, which will be “much more complex” than previous phases.

In his report to the meeting, Dr More said: “Now we seem to be entering a third phase which will see real challenges in the forthcoming winter months.

“This phase is much more complex, much less clear in a sense than those which preceded it.

“We still have Covid-19, such that it is reducing our bed capacity significantly. We have a tired workforce. We have a system under pressure and pent-up demand, which is most evidently shown, as it often is, in pressure on the emergency department.

“We also have major challenges in addressing waiting lists.”

Chief executive Roland Sinker said the trust had been preparing for this point and had mobilised “pivot point three” to try and deal with the “significant challenges” being faced.

He told the meeting that part of the ‘pivot’ would mean being “really flexible” in how the staff in the hospital work and support each other, with a focus on discharging patients “appropriately” before 10am.

A report presented to the meeting identified ‘areas of challenge’ that are being faced by the trust, which highlighted the pressures on the emergency department, with demand continuing to be above pre-pandemic levels.

The report said this demand was being “particularly driven” by self-attendances, NHS 111 referrals and paediatric activity.

It added that the demand has “led to very significant crowding, ambulance offload delays and very long lengths of stay times”.

According to the report, in September, some 1,005 patients had an emergency department ‘journey time’ in excess of 12 hours, compared to 45 patients in September 2019.

Dr Ashley Shaw, trust medical director, said others at the meeting may have seen the reports in recent weeks of the ambulance queues outside Addenbrooke’s A&E, and said “on occasion” some patients had been treated outside.

He said: “Unfortunately there was a case of a patient who had to be treated in an ambulance who unfortunately died. We are supporting the family of that unfortunate patient.

“An initial review has shown we don’t think the outcome of the case would have been different in the hospital, but the experience for everyone involved was very difficult.”

Dr Shaw said they are “constantly working” to see how the “flow” in the emergency department can be improved to “reduce the risk of anything like this happening again”.

Another “major challenge” being faced in the hospital is outbreaks of Covid-19 on the wards, the meeting heard.

According to a report, 91 per cent of patients who contracted Covid-19 while in hospital were infected by other patients.

Roland Sinker, Chief Executive of the CUH Trust at Addenbrooke's Treatment Centre, Keith Day Rd, Cambridge in 2017. Picture: Keith Heppell. (53013105)
Roland Sinker, Chief Executive of the CUH Trust at Addenbrooke's Treatment Centre, Keith Day Rd, Cambridge in 2017. Picture: Keith Heppell. (53013105)

Dr Shaw told the meeting that the outbreaks on wards “appear to be originating” from patients who initially tested negative for Covid-19 on arrival at hospital.

He said that as rates of infection in the community increase, the chances of outbreaks in hospitals will likely increase.

Dr Shaw said that outbreaks in the hospital had led to beds and wards being closed, but had not led to any patients becoming ill.

The meeting heard how work is progressing to make more beds available with a new 19-bed ward having opened in May, and a new 56-bed unit and a 40-bed unit planned to open next year.

Dr More said it was important the trust was honest with the public when describing the challenges being faced.

He said: “It is a very, very challenging period, and we have a very challenging winter ahead.

“As a board and as a hospital we have been very clear about that and have said so publicly.

“I recognise the point of view of members of the public of potential alarm about the situation and we recognise that, but it is important that we are straightforward and honest describing the situation.

“We will not leave, so to speak, stones unturned, and we will not leave questions unasked if there is anything else we can be doing.

“We will continue that because that is the responsibility we have to Cambridge and the wider community.”

Read more:

Investigation after patient dies in ambulance outside ‘extremely busy’ Addenbrooke’s Hospital A&E department

Addenbrooke’s in Cambridge ‘ceasing to function as a hospital’ and may send patients to Birmingham or London, warns chief executive

Plans for early designs for £220m Cambridge Children’s Hospital submitted

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