Ambulances queuing outside hospitals for hours, patients in A&E waiting more than half a day to be admitted and cancelled surgeries – this is the current picture of the Derbyshire NHS.
This winter, day after day, Derbyshire’s NHS organisations have raised the highest level of alert – known as OPEL 4 – declaring that there are significant risks to patient safety and quality of care due to ongoing pressure.
This week, from January 6-7, that culminated with East Midlands Ambulance Service (EMAS) declaring its first critical incident, following more than 40 consecutive days at OPEL 4.
While that “unprecedented” critical incident has now been stood down, the organisation remains at its highest alert level.
Data from Joined Up Care Derbyshire – which oversees the county and city’s health and social care organisations – shows that on January 7 there were 85 patients held in ambulances outside hospitals during chilling conditions, due to a lack of bed capacity.
Of these, 58 were at Royal Derby Hospital and 25 at Chesterfield Royal Hospital.
Meanwhile, there were more than 105 “lost hours” with ambulance crews waiting outside hospitals for patient handovers to be completed – the equivalent of eight shifts.
A total of 45 ambulances were waiting outside Derbyshire hospitals for more than an hour – 41 at Royal Derby and four at Chesterfield Royal.
Data for the University Hospitals of Derby and Burton NHS Foundation Trust (UHDB) shows numerous “areas of concern” including “emergency department waits for admission, long waits to be seen, minimal capacity and discharges identified across site, no trauma capacity”.
UHDB says it does have trauma and intensive care unit capacity and that the data shown by Joined Up Care Derbyshire has not been verified.
It is on the highest level of alert and details that 53 patients waited 12 hours or more to be admitted and 202 patients waited more than four hours.
The organisation only saw 52 per cent of patients within four hours, data shows, but the trust disputes this, claiming “unverified” figures show it was actually 66.3 per cent.
It says no surgeries have been cancelled but says there is currently a 12-and-a-half hour wait to be seen in A&E and a 38-patient queue in the Medical Assessment Unit.
The trust says no planned operations have been cancelled at Royal Derby but “fewer than 30” have been cancelled and rearranged at Queen’s Hospital in Burton “due to urgent and emergency care pressures”.
There were 91 patients medically fit to be discharged home or to a care facility but continued to take up beds due to discharge delays, data shows, with the trust saying this impact was a “significant factor currently affecting bed availability”.
Chesterfield Royal Hospital NHS Foundation Trust is also at OPEL 4 and details that a number of non-urgent elective surgeries have been cancelled.
A spokesperson confirmed: “A minimal number of non-urgent elective surgeries have been cancelled but all emergency, urgent and trauma cases continued. We continue to undertake all elective planned surgery and continue to assess this daily.”
It also shows only 52 per cent of patients were seen within four hours at its A&E, with 29 patients not admitted within 12 hours and 108 not admitted within four hours, with a more than four-hour average wait in A&E.
Will Legge, deputy chief executive at EMAS, said: “The immediate actions that hospitals, partner agencies, and integrated care systems took, and the incredible hard work of our staff and volunteers, means that the number of patients awaiting an ambulance response has significantly reduced.
“The NHS across our region is fragile. This first week in January is historically one of the busiest for the NHS. This year, flu, Covid-19, RSV (respiratory syncytial virus) and norovirus, are adding additional pressure for all services.
“Therefore, although we have stood down the Critical Incident status, we remain at Level 4 – the highest level – of the Resource Escalation Action Plan (REAP).”
Richard Henderson, the organisation’s chief executive, has written in a report to be discussed next week: “I continue to be concerned for the safety of our patients and the welfare of our staff due to hospital handover delays, which have been significant in some of the hospitals in our area.
“Increased handover delays and pressures across the NHS have directly impacted our ability to get to some patients as quickly as we need to.
“The situation we face is not acceptable and we continuously work to influence improvements.”
A UHDB spokesperson said: “In the first week of 2025 our teams have cared for more than 6,000 patients through our emergency departments, so first and foremost we want to thank our staff who, despite huge demand pressures, have worked relentlessly to provide care and keep patients safe.
“While the NHS plans well ahead for winter, peaks in demand do put additional pressure on our services and unfortunately that can mean that some patients wait longer than we would like while we care for the sickest people first.
“We urge our communities to think about the right service for their needs – for conditions that are not life-threatening you will always be seen quicker in urgent treatment centres and minor injury units than a very busy A&E. If people are not sure what service they need, then NHS 111 online or on the phone is a good way to get advice.”
Zoe Notley, deputy chief operating officer at the Chesterfield Royal Hospital trust, said: “We continue to be very busy and caring for some very poorly patients who need our help.
“As ever, we continue to prioritise patient care based on clinical need, and we are here for those that need us the most.
“Whilst conditions are challenging, we are coping and continuing to monitor our staffing levels and capacity throughout the day.
“We do not take the decision to cancel any surgeries or appointments lightly, and urgent and trauma cases have been prioritised.
“Any patients who had their elective non-urgent surgeries cancelled this week will be rebooked as soon as possible.”
A spokesperson said temporary wards were being set up to manage “additional needs”.
They said: “To help manage the situation and reduce the strain on hospital resources, the public is advised to:
Get vaccinated: Ensure you are up-to-date with flu and Covid-19 vaccinations to reduce the risk of severe illness.
Practise good hygiene: Regular hand washing and using hand sanitisers can help prevent the spread of viruses.
Think which service: Use NHS services wisely. Consider using NHS 111 for non-emergency medical advice and only visit A&E for genuine emergencies.
Support vulnerable individuals: Check on elderly or vulnerable neighbours and family members to ensure they are well and have what they need.
“We appreciate the community’s understanding and cooperation during this challenging time. Our staff are working tirelessly to provide the best possible care to all patients.”
