Hospitals prepare for winter pressures

Illness prevention is at the heart of plans by West Midlands NHS chiefs as they brace themselves for the annual winter pressures.

Hospitals in Dudley, Sandwell, Stafford, Walsall and Wolverhampton have all been working on their plans to ensure they can cope with the seasonal spike in admissions during the colder months. 

And the NHS has been working to keep admissions to a minimum by offering free flu and coronavirus jabs to patients over the past few weeks.

Richard Beeken, urgent and emergency care lead for hospitals in the Black Country, says his staff are preparing for what they expect to be a 'challenging winter'.

"Supporting people to stay well is a key part of our winter plans and this includes making sure people who are most at risk from winter viruses, such as flu and COVID-19, are vaccinated to help protect them from severe illness," he says.

“Our aim is to ensure patients have access to high quality urgent and emergency care services in the right place at the right time, delivered by the right professional."  

 But Mr Beeken says the public also have a role to play by using NHS services wisely over the winter months.

"By simply thinking about which service to use before acting, we can help to make sure everyone in our local community gets the right help at the right time,” he says.

The Black Country Integrated Care System, which manages hospitals in Wolverhampton, Walsall, Sandwell and Dudley, set up a central control centre in December 2022, to bring different NHS services together. The control centre will play an important role in monitoring the flow of patients across the region who are in need of urgent and emergency care.

Last winter saw the introduction of specialist hubs to deal with respiratory infections, and these will be available once more this year.

"They were seen as contributing a positive impact for those requiring services particularly out of hours that would normally have been seen by their GP, emergency department or urgent treatment centre," says a spokesman.

The organisation says the Black Country has led the way in the expansion of virtual wards - which allow patients to be treated at home.

"We were the first system in England to introduce virtual wards for children," the spokesman says. 

"Virtual wards will continue to operate across all four of our acute trusts, and Dudley Group Foundation NHS Trust will increase their capacity by 20 beds this winter."

Sandwell urgent treatment centre will see its hours expanded to 18 hours a day,  while seven additional cubicles will be made available at Walsall Manor Hospital's A & E department.

Walsall Manor will also get an extra 27 beds, while  10 paediatric beds will be created at New Cross hospital in Wolverhampton.  

"The interventions we are putting in place are chiefly aimed at helping people stay healthy at home and avoiding admission to hospital," says Mr Beeken. 

" Where possible we know it is best for people to be looked after in their own homes and this is what we are prioritising this winter." 

This are the plans for the main hospital trusts across the region:  

Walsall Healthcare NHS Trust

At Walsall Manor Hospital, seven additional cubicles are being constructed in its emergency department, the work due to be completed by Christmas. 

Twenty-one additional medical beds and six additional surgical beds are also being made available.

Building on the success of the Covid-19 safe at home virtual ward in Walsall, the trust has developed and implemented several additional virtual wards which offer care and recovery at home as an alternative to hospital.

"In Walsall, we have a total of 78 beds available for patients with conditions spanning acute respiratory infection, frailty, palliative care and heart failure," says a trust spokesman.

"We can also offer care and support at home for patients who would otherwise remain in hospital whilst awaiting further investigation or needing close monitoring."

Royal Wolverhampton NHS Trust

At New Cross Hospital, an additional 10 paediatric beds are being made available. The clinical and non-clinical teams both offer support to reduce the number of patients being brought to A & E by ambulance or being directed by the NHS 111 telephone line.

The teams also work with West Midlands Ambulance Service and 111 to direct patients to community services where appropriate.

Services have been improved to increase rapid access to social care in the home. A 'falls response service' was set up earlier this year, which includes issuing patients with pendants to alert emergency services if they have falls in the home.

Dudley Group NHS Foundation Trust 

Diane Wake, chief executive of the trust which operates Russells Hall, Dudley Guest and Corbett hospitals, says there will be a growing emphasis on treating patients at home or in care hones through an expansion of the 'virtual ward' service.

“With another challenging winter ahead, here in Dudley we have made plans to ensure we deliver the very best care to our patients as we know winter always brings more health challenges for our communities," she says.

"We will be specifically focusing on our virtual wards, our home-for-lunch programme and our staff out in the community to help ensure hospital avoidance and patients receiving treatment in the comfort of their own homes where possible.

"We are working very closely with our partners to ensure all patients receive the right care and treatment in the right place.

"We would ask that the public also play their part by taking simple steps to look after themselves, loved ones and checking in on vulnerable family members and neighbours and get your winter vaccines for both flu and Covid-19."

Mrs Wake said the trust would continue to work closely with care organisations and local authorities to help speed-up hospital discharges and ensure people get the care they need in the community.

The trust now operates six 'virtual wards' specialising in paediatrics, respiratory conditions, frailty, cardiology, nutrition and pharmacy. It says these are providing significant cost savings as well as improving patient care.

Mrs Wake says that since the frailty virtual ward was introduced in January 2023, it has helped avoid 8,736 bed days by reducing unnecessary admissions.

Since its launch in March, 2022,  the trust's virtual paediatric ward has managed more than 1,000 children, saving more than 4,500 bed days. 

Mrs Wake says the 'home for lunch' scheme has led to patients being discharged more efficiently once they are well enough to return home, including at weekends. This, in turn, has created more space for patients in need of treatment.

Sandwell & West Birmingham NHS Trust

Following Sandwell hospital’s move to the new Midland Metropolitan University Hospital in early October, staff at Sandwell & West Birmingham NHS Trust staff are preparing to fully open the hospital.

The new hospital in Smethwick has a dedicated children’s A & E in addition to the adult department, and will offer more efficient care with all specialties under one roof. 

Benefits include heart attack patients being taken to an on-site cath lab for diagnosis, and stroke specialists being able to assess patients within A & E.

The Midland Met will also have inpatient wards, maternity, children’s department, critical care, and the Sickle Cell and Thalassemia Centre.

Chief executive Richard Beeken, who is also the leader of hospital services at Black Country Integrated Care System, says: “Our ambition is to provide the focus to ensure staff are in the position to deliver the right care for our patients whether that’s acute care or care via our community services like the virtual wards, stroke rehabilitation at Rowley Regis Hospital, or at home."

An urgent treatment centre will still be available at the former Sandwell Hospital in West Bromwich, which will be open from 7am-1am, seven days a week. 

"The urgent treatment centre is for ailments which are not life threatening but still need attention, including sprains and strains, suspected broken bones, injuries, cuts and bruises, stomach pain, vomiting and diarrhoea, skin infections and rashes, high temperature in children and adults and mental health concerns," says Mr Beeken.

The former Sandwell Hospital, now known as Sandwell Health Campus, will continue to deliver outpatient appointments, short-stay surgery, day treatment and a chemotherapy unit.  

County Hospital, Stafford

The hospital plans to work with other NHS agencies to ensure that only those who really need to be in hospital are admitted, and also to ensure they do not spend longer on the wards than they need to.

Special focus will be given to frail and elderly patients, to ensure that they are prioritised according to their needs.

Tommy Murphy, divisional director of operations for medicine and urgent care, says: “Over the winter months, the NHS sees more people attending A & E, and therefore, the highest increase in the number of people being admitted to hospital."

"The new Frailty Assessment and Same Day Emergency Care Service will assess and manage frail and elderly patients requiring urgent or emergency input. This will ensure patients receive timely and appropriate care allowing them to return to their home residence at the earliest opportunity.

 “We are also working with our NHS partners to provide additional community and home-based services to ensure people can be cared for at home where it is appropriate to do so, rather than be admitted to hospital unnecessarily."

He adds that great effort will go into ensuring patients receive the appropriate care at home, so they can be discharged as quickly as possible.

Mr Murphy says the public also has a role to play in reducing pressures, through responsible use of A & E, and taking advantages of support provided by their local chemist shop, GP,  walk-in centre or the 111 telephone service.

He says A & E and 999 ambulance services should only be used in critical or life-threatening situations. 

"You should only attend A&E for anything classed as an emergency including choking, chest pain, loss of consciousness, severe blood loss, broken bones, difficulty breathing, deep wounds or a suspected stroke," Murphy adds.

"There are various alternatives NHS services to A & E available in the Stafford and wider Staffordshire area, which may be able to treat your condition more appropriately:"