Feature: Sick state of hospitals

Senior accident and emergency nurse Matthew Hutchinson has seen many changes during more than ten years at the Royal Sussex County Hospital in Brighton.

Patient numbers have risen sharply and staff face increased pressures to meet demand.

The Royal Sussex sees about 80,000 people every year and the figure is rising.

Mr Hutchinson said: "The demand now is constant and we are nearly always working at full stretch.

"A few years ago you could have quiet periods during the year when things were relatively calm, but now it feels we are busy all the time.

"Because of this some patients have to wait longer for treatment than they or we would like, which can make things difficult.

"However, we are constantly looking at ways to improve things. This includes speeding up the flow of patients passing through A&E by assessing them as soon as possible and steering them in the right direction to try and prevent bottlenecks from building up."

The vast majority of patients seen are happy with the treatment they get and pass their way smoothly through the hospital system until they are discharged.

But, as with other A&E departments at Sussex hospitals, other patients discover things do not run as smoothly and find themselves lying on trolleys for hours while waiting for a bed to be found.

Other pressures include dealing with the women with suspected breast cancer who often have to wait longer than the stipulated two weeks between being referred by their GP and seeing a consultant.

Thousands of patients in East and West Sussex are on the waiting list for non-emergency operations and all hospitals are struggling to reduce the numbers.

Brighton Health Care NHS Trust and West Sussex Health Authority have the dubious honour of having some of the worst results in the South-East when it comes to seeing women with suspected breast cancer and keeping people waiting a long time for operations.

Hospital bosses now say there is no such thing as "winter pressures" because they are experiencing pressures all year round.

A critical shortage of nursing home beds throughout Sussex means bed blocking in hospitals has become a serious problem.

At Eastbourne there are an average of 50 patients waiting at any time to be transferred from the hospital to a nursing home and its bosses warn this could deteriorate.

A spokesman for Eastbourne Hospitals NHS Trust said: "We are working with social services to try and deal with this because, apart from being upsetting for the patients, it also has a knock-on effect on other services."

At its recent annual meeting, the chief executive of Brighton Health Care Stuart Welling said his hospitals were running at 96 per cent capacity on average, with some wards reaching 100 per cent plus.

In an ideal world hospitals should be at 85 per cent capacity so patients can be found a bed as quickly and smoothly as possible.

Mr Welling said: "Part of the problem is that we don't have enough beds to cope. But the other is discharging patients ready to leave.

"This is down to a critical shortage of nursing home places to move patients into."

It is not just lack of nursing homes beds that cause delays but also staff shortages.

All hospitals in Sussex are struggling to recruit and keep nursing staff and other vital workers.

Dozens of graduate doctors a year are turning to private medicine or taking up research options.

In Brighton and East Sussex many nurses are moving to work in West Sussex where they are eligible for a bonus worth hundreds of pounds a year.

Mr Welling said: "This has caused us quite a few problems and we have seen staff turn a job offer from us down and go to West Sussex instead.

"The discrepancy is starting to have an impact on us now and is causing us concern. We are working closely with our MPs to tackle this."

Some patients are now so fed up with waiting months for treatment, they are going abroad instead.

The Argus recently reported how former soldier Don Higgins, 77, from Crawley, went to Germany for a cataract operation after being told he would have to wait 12 months for treatment at Crawley Hospital.

Hospitals will admit they are facing problems but are working flat out to tackle the difficulties.

Part of the Government's solution is to go back to basics by giving local organisations the power to commission hospital services in their area.

In the past East Sussex, Brighton and Hove Health Authority and West Sussex Health Authority have had overall responsibility for deciding what is spent on which services.

But next April the authorities will be merged with two in Surrey to form a strategic health authority responsible for overseeing hospital performances.

The day-to-day provision of services will become the duty of local primary care trusts.

Department of Health spokesman Nigel Edwards said: "We think local organisations have a better idea of what is needed locally and will be able to get to the heart of people's needs."

Hospitals are also building closer links with other organisations such as GPs and social services to integrate services as much as possible.

At Brighton work is already under way to expand the cardiology and renal unit at Royal Sussex and more intensive care beds have been provided to cope with demand.

A Medical Assessment Unit has also been developed at the hospital to provide a place for A&E patients while waiting for a bed on a ward.

Brighton Health Care hopes a planned merger with neighbouring Mid Sussex will also improve patient services.

Proposals include building a centre of excellence for cancer care at the Princess Royal Hospital, Haywards Heath.

Eastbourne Hospitals and Hastings and Rother NHS Trust are also planning to merge and say that, by working in partnership, they can tackle problems such as waiting list times more effectively.