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NHS staff making a difference this winter - treating patients with long-term conditions

Unprecedented numbers of patients have been accessing NHS services in the region with staff dealing with the highest ever number of A&E attendances and emergency admissions.

This is in addition to record highs in the numbers of 999 calls to ambulance services and calls to NHS 111, and increasing demand on GPs.

Cold weather is harmful to health. Around 25,000 more people die over the course of each winter compared with other times of the year. Heart attacks increase, and admissions of patients for stroke and respiratory conditions increase significantly between 5 and 12 days after the start of a cold snap.

GPs and primary care clinicians see and treat 90% of all illness episodes, and for every one degree centigrade temperature drop below five degrees, there is a 10% increase in the number of older people consulting their GP for breathing problems.

As part of NHS England's Five Year Forward View plan, improved access to general practice service schemes now mean that evening and weekend appointments are available to North Cumbria and North East residents but the winter pressures are acute.

Dr Jonathan Slade, NHS England's Deputy Medical Director, in Cumbria and the North East, and a practicing GP in Stockton-on-Tees, said: "Improved access is improving care but we are seeing a lot of people this winter with minor ailments who could self-care and free up appointments for those who really need to see their GP.

"We urge people to see their local pharmacist at the first sign of illness and self-care for common ailments like a cough, colds, and sore throats as these are usually viral and do not get better with antibiotics.

"If you have symptoms that are severe, or getting progressively worse, that's the time to contact your GP practice, and if you need advice fast, call NHS 111. For medical emergencies dial 999. A&E is for serious accidents and emergencies only."

In winter, the number of hospital admissions due to respiratory illness doubles and A&E departments across the country are feeling the strain. 90% of patients in the region are currently being treated and discharged within the national four hour target.

Clive Kelly, a consultant in acute medicine who is running the winter pressure ward at The Queen Elizabeth Hospital, Gateshead said: "We are treating large numbers of people with respiratory illness. We structure our week so that every patient is seen each morning by me and the team starting with new admissions. 

"Diagnosis, treatment, outcome, results and discharge date are all reviewed daily, and we go back in the afternoons to repeat the process.

 "We're seeing many elderly patients and although the average age of our admissions is 84, we're managing to get them well enough to leave hospital in about 6 days.

 "By comparison, the length of stay for patients placed on wards without dedicated medical staffing is around 12 days and patient satisfaction much lower.

 "Our approach has had a big effect on the availability of hospital beds, and although we're working with locum junior doctors and nurses, the system is proving remarkably effective with very high levels of patient satisfaction."

 Flu and the winter bug, Norovirus, are adding to the difficulties faced by hospitals and staff are working round the clock to prevent and reduce transmission.

 Dr Neil Munro, consultant, Respiratory Physician, County Durham and Darlington NHS Foundation Trust, said, "This winter, hospital services in County Durham and Darlington have experienced a prolonged period of intense pressure on our inpatient beds.

"Respiratory diseases with particularly high levels of influenza related illness in our increasingly frail elderly population have stretched our services. We have risen to the challenge with increased bed capacity, improved diagnostic services and clinical staff altering work patterns to ensure these additional patients are seen and treated in a timely fashion.

 "I would like to applaud the hard work and dedication of my clinical colleagues in coping with these testing times. I would urge anyone with respiratory symptoms, particularly those with pre-existing chest conditions, to seek advice promptly from their GP or pharmacist rather than put off and risk deterioration."

Dr Nick Roper, Clinical Director, North Tees and Hartlepool NHS Foundation Trust, said: "At North Tees and Hartlepool NHS Foundation Trust we always put our patients first. Our Accident and Emergency department is a priority system where the most poorly or injured patients are seen first.

 "It is important that we are able to provide emergency treatment to those who are most in need. If you are unsure you can call the NHS 111 service to speak to a trained call handler who can arrange for you to be seen by an out of hours GP service or call an ambulance if that's what you need.

 "Your local pharmacist may also be able to help and having a fully stocked medicine cabinet is also advised."

Conditions worsened by the cold, including circulatory diseases such as heart disease and stroke, and lung illnesses such as Chronic Obstructive Pulmonary Disease and asthma, along with dementia, account for 80% of winter deaths.

Dr Slade added: "Stay well this winter through self-care and help your neighbours and family during cold weather. Wrap up and keep warm in winter. There are still 3 million people in the high risk groups for flu and it is still not too late to get the free flu jab to protect yourself."

 Published 30 Jan 2018

'I cannot commend the clinic enough. It is marvellous we have this service at all and well done to you all.'

Patient, Coronary Heart Disease / Heart Failure Service, Shotley Bridge Community Hospital