Nottingham University Hospitals Trust could not have reasonably anticipated the busiest winter on record, says Peter Homa

The cumulative effect of a number of factors led to the busiest winter on record for the trust. Attendances in December were 13 per cent higher than planned and 23 per cent higher for patients over the age of 65.

‘Our planning for winter as a health and social care system was stronger than ever’

The 3 per cent increase in emergency admissions, particularly among older and very poorly patients who had longer lengths of stay, and the early arrival of flu and norovirus impacted significantly on our capacity and flow over this period.

We made very careful assessments on how busy we would be based on activity in previous years and our planning for winter as a health and social care system was stronger than ever.

As a system we invested more than £10m of resource, which included 70 extra hospital and 48 community beds, as well as an expansion of our emergency department, along with other innovative developments to improve the timeliness of emergency patient care and reduce delays when patients are ready to transfer from our care.

Peter Homa is Nottingham University Hospitals Trust chief executive

Peter Homa

Yet, we still could not have reasonably anticipated the exceptional winter we faced. We welcome the national research and analysis of this winter to inform planning for the coming year.

With regard to our ongoing challenges, it is imperative that funding for the capacity and resources that were in place for winter continue beyond April. Early announcements regarding the allocation of 2015-16 winter monies are required in order to give trusts maximum time to recruit staff to these posts.

Longer term, we need to assess our plans for the future to ensure we have a sustainable workforce, with recruitment to nursing and many clinical posts increasingly challenging.

We continue to work closely and effectively with our health and social care partners to reduce delays when patients are ready to transfer from our care (especially those who require complex care packages) and reduce numbers of patients occupying our beds who no longer require acute care.

Peter Homa is chief executive at Nottingham University Hospitals Trust

The presentation was given at the Emergency Care summit held by HSJ and McKinsey Hospital Institute on 12 February. The event was held under Chatham House rules but presentation speakers have given permission on being identified.