Inside Greater Manchester’s hospitals as highest pressure level declared

As the country approaches another cold snap, national health bosses say the pressure might only continue to rise

Hospitals have been ‘tipped over’ into that highest alert level by a combination of factors(Image: PA)

Greater Manchester hospitals are under ‘significant duress’, according to the region’s most senior health leaders, as they have moved ‘in and out’ of the NHS’s highest pressure level in recent days.

Hospitals have been ‘tipped over’ into that highest alert level by a combination of factors, senior NHS sources have told the Manchester Evening News. And as the country approaches another cold snap, national health bosses say the pressure might only continue to rise.

Greater Manchester health leaders confirmed yesterday (January 21), that some of the region’s hospitals have moved ‘in and out of OPEL 4 over the course of the last few days’. OPEL 4 refers to the NHS’s operational pressure levels, with level four being declared when a hospital is unable to deliver comprehensive care and patient safety is at risk.

Trusts across Greater Manchester had 94.6 per cent of beds occupied a day on average during the week ending January 18, according to the latest NHS figures. That’s up from 93.9 per cent a week earlier and is the highest rate so far this winter.

An average of 39,624 beds were occupied each day out of a total of 41,874. And all acute trusts across Greater Manchester have been operating at above 90 per cent of bed capacity.

The combination of reasons for high pressure includes the spike in demand seen by the NHS every winter, as people are more likely to get ill or suffer falls. In December, Greater Manchester was hit hard by a wave of flu, while national bosses warn of a rise in norovirus cases this month.

Bed occupancy rates in Greater Manchester(Image: Reach Data Unit)

All of this contributes to more people coming to A&E, where they can wait days as emergency department staff try to cope with the uptick in volume – or for beds becoming increasingly scarce as more people are admitted than discharged.

Staff, too, aren’t exempt from winter bugs, meaning there’s often fewer workers to deal with patients coming into hospital, again resulting in longer waits in A&Es.

Delayed discharges remain a national problem. That’s where patients who are medically ready to leave hospital can’t be discharged because the right care, support, or placement isn’t available immediately in the community.

The M.E.N. reported in 2021 how Sir Richard Leese, the chair of NHS Greater Manchester, said anything beyond 85pc of beds occupied is ‘very uncomfortable for hospitals’. But the region’s hospitals have been routinely more than 90 per cent full in recent years, with hundreds of beds occupied by people medically ready to go home.

Some hospitals have been busy with long waits in A&E but ‘coped’, according to senior sources in the region. The M.E.N. understands that, so far, this winter has not been as quite severe on Greater Manchester’s hospitals as some in recent memory.

There are hospitals in the area that have ‘tipped into OPEL 4, but this hasn’t been sustained’.

Nationally, NHS figures released today show more general and acute hospital beds were occupied in the week ending January 18 (94.5 per cent) than at any point during the middle of January since 2020 (95 per cent).

The busy week has been driven by a rise in norovirus, the ‘vomiting virus’, as the NHS also prepares for a predicted cold snap this weekend and into next week.

There were an average of 823 patients in hospital with norovirus each day last week – the highest number so far this winter – and up 45 per cent on the previous week and more than double what it was a fortnight ago (361).

NHS National Medical Director Professor Meghana Pandit said: “A rise in this vomiting virus is leaving hospitals under pressure. Norovirus cases didn’t peak until February last winter, so we’re monitoring closely for further increases ahead of another predicted cold snap this weekend.”

Some hospital trusts have reached that highest level of alert, but the whole of Greater Manchester has not been at that level at any point(Image: Manchester Evening News)

During a meeting of the Greater Manchester Integrated Care Board, which plans and pays for NHS health care in the region, acting chief executive Colin Scales said: “We are in a really difficult position in Greater Manchester at present in respect of the demand for urgent care that’s being experienced.

“We have moved in and out of OPEL 4 over the course of the last few days. Some trusts are under particular pressure, some sites within trusts are under even greater pressure than that.”

Mr Scales said that pressure on urgent care in hospitals had been well managed before Christmas. The region’s hospitals were at around 80 per cent capacity, considered by NHS leaders as acceptable during the depths of winter, when demand is highest on the NHS.

“While the pressures during the course of the Christmas period and the run up to Christmas enabled us to get to a position of 80 per cent which was great in anticipation of the demand that was going to come,” he said.

But now, the region’s hospitals are ‘under significant duress’. Mr Scales continued: “We are continuing to support the system, expediting discharge and managing demand for urgent care.

“It’s important for us to know that the system [as can often be the case in January] is under significant duress.”

Escalating OPEL levels it can allow for the pausing of less urgent work so resources can be directed to the most urgent patient care as it’s needed.

The integrated care board, also referred to as NHS Greater Manchester, said that some hospital trusts have reached that highest level of alert, but the whole of Greater Manchester has not been at that level at any point. It has not been confirmed which hospitals have been on the highest level of pressure.