ERI runs out of beds

A SPATE of car crashes coupled with a huge rise in bed-blocking in the past month led to Edinburgh Royal Infirmary running out of beds, it emerged today.

Health chiefs were on the verge of cancelling non-emergency operations until they managed to move 14 patients to community health facilities. The situation on Tuesday followed last week's revelation that more than 1000 beds had been lost in Lothian over the past decade, with NHS Lothian insisting it was trying to make sure it did not keep empty beds at an unnecessary cost to the taxpayer.

Bed-blocking, or delayed discharge, levels had fallen below 50 for the first time since records were started in 2000, thanks in part to a £7.7 million deal between NHS Lothian and the city council to provide more care home places.

However, since April that number has more than doubled to 108, in what health chiefs have described as a "blip".

The ERI operates a traffic-light system where red warns that they are running low on beds. When this happens one option is to move patients to St John's or the Western General, but it is understood they were also at capacity on Tuesday.

The ERI also has the busiest A&E department in Scotland, seeing more than twice as many as its nearest rival.

Problems were exacerbated over the weekend, when a series of car crashes led to 22 patients being brought to A&E at the ERI suffering from serious injuries and requiring resuscitation.

Eddie Egan, employee director and vice chairman of NHS Lothian, speaking at yesterday's health board meeting, said: "Yesterday no beds were available at the ERI. A huge amount of doctors' and nurses' time was spent – not looking after patients – but trying to find somewhere for them to go."

He added: "We had a case conference to see if we would stop elective surgery. We then got the 14 beds and did not have to."

NHS Lothian has run initiatives to persuade patients not to turn up at A&E when their problems are more suited to attending a GP's surgery or calling NHS 24. However, it has become a victim of its own success in hitting Scottish Government waiting time targets.

James McCaffery, NHS Lothian's director of acute services, said it was an "exceptionally busy weekend" but insisted the doors were not closed to patients at any point.

He said: "We have a highly effective early warning system which allowed us to respond to the situation through careful management and making use of some beds in social care settings.

"Another factor that has created pressure on the system is that we have a temporary blip in the number of patients being delayed in hospital when they no longer need to be there but who have nowhere else to go.

"Last month we were ahead of target with just 50 delayed discharge patients in Lothian but the number has now risen to 108. We are working closely with our colleagues in the local authorities to get the excellent progress we have been making in cutting delayed discharges back on track as soon as possible."

Margaret Watt, chairwoman of the Scotland Patients Association, highlighted the narrow margin for error when it came to patient numbers. She said: "We have been concerned since the number of hospital beds in Scotland were cut two years ago, from about 19,500 to less than 18,000.

"Obviously you cannot legislate for a lot of people taking ill at once, but it's all a wee bit too neat."

• www.nhslothian.scot.nhs.uk