FOI reveals extent of ‘extreme pressures’ faced by North Wales hospitals

North Wales hospitals have been under the most severe level of pressure more than 2,000 times since 2015, according to ‘frightening’ new figures.

Statistics released under the Freedom of Information (FOI) Act show Wrexham Maelor Hospital, Ysbyty Glan Clwyd and Ysbyty Gwynedd have been at level four, described as ‘extreme pressure’, on 2,185 occasions up to August this year.

Glan Clwyd in Bodelwyddan faced the biggest strain, accounting for almost half (1,032) of instances, compared to 505 at the Maelor and 563 at Bangor’s hospital.

The situation has grown significantly worse since 2015 when hospitals only reached the top level 120 times, in contrast to 977 in 2017.

Last year Glan Clwyd hit level four more than once a day (469), but while its situation has improved in 2018, the Maelor has already arrived at the trigger point more times as of August (182) than in the whole of 2017 (174).

North Wales Assembly Member Llyr Gruffydd said the data showed the three district general hospitals are operating at ‘almost permanent’ crisis levels.

He said: “The dramatic rise from 120 incidents in 2015 to almost 1,000 by 2017 demonstrates that staff are being pushed to breaking point.

“While 2018 has seen a decrease overall it’s hugely worrying to see that Wrexham hospital has levels of Level 4 escalation that are already higher this year than last year, and we’re only in August.

“Betsi Cadwaladr health board has been under direct Welsh Government control over the last three years and we’ve seen this happen.

“What will it take for this Labour Government to accept its part in the mismanagement of our NHS?”

The four levels demonstrate how much pressure emergency departments in Wales are under and how hospitals should response.

According to an official document, level four is met when admissions are significantly above the expected number and available capacity, and patients are left waiting more than four hours to be seen.

Triggers include if emergency departments are unable to cope with demand and ambulance patients have waited more than an hour to be handed over to hospital staff.

It can also occur when there is a lack of capacity in the coronary and intensive care units.
The document states that the situation should be brought to the attention of the health board’s chief executive and Welsh Government.

In response to the figures, Betsi Cadwaladr said escalation levels can change throughout the day.

Executive director for nursing and midwifery Gill Harris said: “We have been open about the challenges we face in improving flow, which are the same as those experienced in most hospitals across the UK.

“Escalation levels are not a performance measure. They are an internal management tool to aid the management of patients through the hospital system and the levels change throughout the day.
“We remain extremely grateful to our staff for their professionalism and dedication to caring for our patients.”

Earlier this month, Health Secretary Vaughan Gething announced a cash injection of almost £7 million for the beleaguered health board, which has been in special measures since June 2015 in the wake of the Tawel Fan mental health ward scandal.

He said the funding would be used to strengthen planned and unscheduled care services and deliver further improvements to mental health and learning disability services.

A Welsh Government spokesman said: “Progress has been made in a number of areas under special measures but we have told the board we expect to see immediate improvements in other areas, in particular waiting times.

“We have, and continue to, place more intensive support to deliver transformational change and improvements needed in planned and unscheduled care and a new chair has been appointed to drive this forward.”

By Liam Randall – BBC Local Democracy Reporter (more here on the LDR scheme).