New figures show that at least one of Derbyshire health and care services have been “unable to deliver comprehensive care” and at risk of patient care and safety being “compromised” on seven out of every 10 days over the past five months.
Figures detailed in a report to Derbyshire County Council show that at least one of Derbyshire health and social care organisations has been on Opel 4 – the highest level of critical pressure – for 109 days out of the 152 days from October 31 to March 31.
Opel 4, often known as a “black alert”, represents the following, as detailed by NHS England and NHS Improvement: “Pressure in the local health and social care system continues to escalate, leaving organisations unable to deliver comprehensive care.
“There is increased potential for patient care and safety to be compromised. Decisive action must be taken by the local A&E delivery board to recover capacity and ensure patient safety.
“All available local escalation actions taken, external extensive support and intervention required.
“Regional teams in NHS England and NHS Improvement will be aware of rising system pressure, providing additional support as deemed appropriate and agreed locally, and will be actively involved in conversations with the system.
“Where multiple systems in different parts of the country are declaring Opel 4 for sustained periods of time and there is an impact across local and regional boundaries, national action may be considered.”
Looking at the detail of Derbyshire’s Opel 4 alerts, this included the entirety of November and December for East Midlands Ambulance Service (EMAS); half of January for EMAS, Royal Derby Hospital and Chesterfield Royal Hospital; 13 days in February at Royal Derby, and a further seven days in March at Royal Derby.
This includes a continuous Opel 4 alert for 79 days in a row at EMAS from October 31 to January 17..
It also includes eight days across October, December and January in which Derbyshire County Council’s social care team declared Opel 4, with issues relating to capacity to accommodate and staff patients needing to be discharged from hospital.
Issues around that pressure over the course of the past few months have led to private beds being commissioned.
The entire Derbyshire health and care service was escalated to Opel 4 for a total of 26 days between November 1 and March 31, issuing media releases advising patients on how best to interact with services despite ongoing levels of sustained high pressure.
It made clear that this included two main issues, the number of people needing to be admitted to hospitals and the number of people who needed to be discharged from hospitals.
Clearing those two issues relies on the entire healthcare system, not just one hospital or one organisation.
The ongoing pressures of catching up on the waiting list of patients, staff shortages and illness, and a combination of patient illness all at once (including flu and Covid) have compounded pressure on the system as a whole.
Here is a detailed breakdown of which Derbyshire health and social care organisations declared Opel 4 and when between November 1 and March 31:
East Midlands Ambulance Service: October 31 to January 17, February 14
Royal Derby Hospital: November 22-25, November 29-30, December 13-22, December 28 to January 15, February 4-9, February 15, February 18-23, March 3-8, March 28
Chesterfield Royal Hospital: November 28 to December 1, December 21-22, December 28 to January 6, January 8-11, January 25-26, February 1, March 21-23, March 29-31
Derbyshire County Council social care: October 31, December 13, December 21, January 3-4, January 6-8
Derbyshire Health United Healthcare GPs: December 5, December 7-9
Derbyshire Health United Healthcare NHS 111: December 5-14, December 16-20
Derbyshire Health United Healthcare out of hours GPs: December 11-13, December 25-29, January 2-3
East Midlands Ambulance Service patient transfer: December 21-22, February 20, March 10
The Derbyshire health and social care system: December 13-15, December 21-23, December 28 to January 13, March 29-31
