• A&E and flow through hospital affected by shortage of beds
  • Trust also struggling with ambulance handovers
  • Trust has closed 100 beds to admissions to minimise covid spread

Staff at a teaching hospital which has struggled with emergency care pressure this winter have warned that patient safety is being compromised as crowding is becoming “normalised”.

A letter sent by a group of clinical staff at Cambridge University Hospitals Foundation Trust to the trust board calls for immediate action to tackle concerns.

It says: “The normalisation of crowding, the lack of effective flow management and the lack of effective escalation policies and procedures are resulting in patient safety, dignity and comfort being repeatedly and seriously compromised.”

Details of the letter were shared with HSJ but it is unclear how many and which staff it is signed by.

A source told HSJ patients were being treated in rooms normally used only for plaster casting, and storage areas, at Addenbrooke’s Hospital, as the emergency department struggled to cope. The trust confirmed that a plaster room had been converted into a clinical assessment space in A&E.

The trust has about 100 beds closed to admissions linked to covid outbreaks, to minimise the risk of spread to other patients – in addition to 100 taken out of use earlier this year to allow more space for infection control purposes.

Over the last few months, the trust has struggled to admit A&E patients to a bed. In October it had 111 12-hour trolley waits and in November it had 154.

Between 7 December and 13 December CUH had between 841 and 850 general and acute beds available, of which 44 to 80 were reported as “unoccupied”, according to NHS England statistics. Between 38 and 48 were occupied by covid patients. At the same time last year, it had around 950 beds open.

The trust also had 83 instances of ambulances waiting more than an hour to hand over patients between 7 December and 13 December this year.

A CUH spokesman said: “Staff are actively encouraged to raise any concerns they have and we meet with emergency department consultant colleagues and other senior clinicians on a regular basis.

“The trust is continuing to improve patient flow in order to release capacity for admissions from the emergency department and ensure patients receive the best possible care throughout the pandemic and into the winter.”

The trust is trying to discharge more patients earlier in the day, increasing senior nursing and operations support out-of-hours and at weekends, and working with other organisations to try to reduce delayed transfers of care.