Health boss lays out the challenges facing Wigan's busy hospital staff this winter

That is the message from Dr Sanjay Arya, medical director and consultant cardiologist at Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust (WWL), which runs the borough’s hospitals.

While the winter months are always busy, the NHS is currently facing even more demand due to the coronavirus backlog, delays in sending patients home and other factors.

More than half of patients had to wait for more than four hours to see a medic in Wigan Infirmary’s A&E department in November and hospital chiefs warned of “exceptionally long waits” there on the weekend before Christmas.

That came as North West Ambulance Service bosses also reported high demand and hundreds of patients waiting to be seen – even before paramedics went on strike.

Dr Arya said: “The NHS is going through very difficult times and the pressures on our emergency department have been high for quite a long time now. It’s the same across the North West and the rest of the country.”

Average daily attendance at Wigan’s A&E used to be between 240 and 250, but staff now see many more patients, sometimes reaching up to 320.

While rates of coronavirus appear to be under control, Dr Arya said, the number of patients admitted with flu has “risen sharply”, and he urged people to get vaccinated, especially children.

There are also more cases of children with group A strep, which can cause scarlet fever, impetigo and life-threatening invasive group A streptococcal disease. There was recently an outbreak at Orrell Holgate Primary School.

Bed occupancy is at nearly 100 per cent every day, meaning it is difficult to find beds for new patients.

Dr Arya said: “If you want to provide safe care, your bed occupancy should be no more than 85 per cent and we have had bed occupancy of 100 per cent for several weeks now. That’s adding to the pressures and patient flow.”

There are also issues with patients being unable to leave hospital when they are medically fit, for example problems with discharging them to care homes.

Dr Arya said: “Sadly we continue to have patients in the hospital who are medically fit to go home. We have got a huge number of such patients still in hospital beds, waiting for somewhere to go.

"Many times there are well over 100 patients who should be going home.”

NHS staff are still working flat-out to provide the best care they can for patients, Dr Arya said.

"Despite all these pressures, our staff – doctors, nurses, therapists – are all working extremely hard to manage patient flow. We are making sure that the quality of care to our patients is kept to the best, despite all of this, and so our staff are working extraordinarily hard to manage that.

"We continue to provide all the essential services. We still want people who need accident and emergency care to come to the hospital – people with heart attacks, strokes, trauma – but if you are not seriously ill, please look for other avenues, like pharmacists, GPs, dental care and opticians. These are the places where people should go but they are still coming to A&E and adding to the pressures.”

Dr Arya praised the efforts of other NHS staff, including GP practices, which he said were “equally under pressure” and doing their best to keep people away from hospitals.

He appealed to Wiganers to do what they could to stay away from hospital, so staff can focus on caring for patients who need their help.

He said: “My request is to please look after yourself. It’s going to be a very harsh winter. Keep yourself covered. Elderly people, please avoid going out because of the risk of falling on ice, which brings a lot of trauma cases.

"If your family members in hospital are getting better, please take them home, because home is the best place to recover. You are less likely to have complications, you are less likely to acquire hospital infections and you are more likely to get on your feet sooner.”

One of the things the trust is doing to help people stay out of hospital is having a “virtual ward”, where patients remain at home but are closely monitored remotely by medical staff.

Dr Arya said: “If we approach our patients for a virtual ward, please be reassured this is a good service which will help you recovery quickly and be under the care of a specialist.”

Other measures taken to help meet the increasing demand for care are having specialists and consultants working at the front of the hospital, opening same-day emergency care and extending the hours for both medical and surgical patients, and working with clinical partners to help discharge patients into care homes.

There are also plans to open extra beds at the hospital, depending on staffing levels, and work has started on a new community diagnostic hub at Leigh Infirmary.

The trust is also working through the list of patients waiting for operations, which grew during the pandemic.

Dr Arya said: “We have not stopped our elective recovery programme, so patients who are waiting for surgery will get that. We intend to continue until the time comes when we get inundated with acutely ill patients.”

Despite current pressures, Dr Arya says he is “very positive” about 2023.

“We have the best healthcare system in the world,” he said. “Yes, it’s going through challenging moments, but the biggest thing about the NHS is its staff. We are very resilient and we all work together to make sure our patients get the best care.”