Covid-19 measures blamed as six in ten A&E patients at North Wales hospital wait longer than four hours

North Wales’ health board has blamed Covid-19 social distancing measures after nearly six in ten patients had to wait longer than four hours to be seen at an A&E department last month.

Emergency department performance figures for the region’s three district general hospitals were the worst in Wales during November.

Delays were at their peak at Ysbyty Glan Clwyd in Bodelwyddan, where only 42.6% of patients (1,662 out of 3,903) were seen within that time frame – the lowest percentage of anywhere in the country.

A total of 667 people were forced to wait more than 12 hours to be checked over at the hospital.

At Wrexham Maelor Hospital 62.9% (2,607 out of 4,143) were dealt with inside four hours, which was the third lowest.

However, Ysbyty Gwynedd in Bangor fared much better with 85.9% (2,821 out of 3,285) attended to within the same timescale.

Betsi Cadwaladr University Health Board, which was recently brought out of special measures, said the delays had been caused by the requirement for social distancing measures within health facilities.

It has resulted in the area’s hospitals having to work with around 70 fewer beds over the busy winter period, with steps being taken to address the situation.

Dr Kate Clark, Acting Deputy Executive Medical Director for Betsi Cadwaladr University Health Board, said: “Measures to separate Covid-positive and negative patients, such as ward segregation, additional infection prevention measures and screening on admission as well as ensuring safe discharge of Covid positive patients into the community has decreased flow through our hospitals and contributed significantly to longer waits at our emergency department.

“We are mindful of the impact of measures to mitigate/reduce the risk of Covid-19 are on emergency department waits.

“The need to follow robust infection prevention measures remains our main priority.

“We encourage everyone to adhere to current government guidance in light of the recently highlighted new variants.

“Measures to improve performance over the winter include the pilot of a new primary care urgent care centre at Wrexham Maelor Hospital, which will also extend to Mold in the coming weeks, and the extension of the existing SICAT (Single Integrated Clinical Assessment and Triage) service to further support our emergency departments and minor injury units.

“Information relating to the services available can be accessed through ‘Where Do I Go? – Betsi Cadwaladr University Health Board (nhs.wales)

“We continue to work closely with our Welsh Ambulance Service colleagues to improve handover times at all of our district general hospitals.

“We are constantly working to improve our hospital flow and discharge rates, which will support our ability to transfer patients from ambulances more quickly.”

The explanation comes despite North Wales experiencing lower infection rates compared to parts of South Wales, where the health system has come under significant pressure in the last few weeks.

However, the health board has warned of a sharp rise in cases of Covid-19 in north east Wales, where it said the numbers were “significantly higher” than in some parts of England, such as Liverpool and Merseyside.

In the seven days leading up to Christmas Eve, more than 1,100 people living in Wrexham and Flintshire tested positive for the virus.

We are seeing a sharp rise in cases of COVID-19 in North East Wales, which is significantly higher than in some other regions, such as Liverpool + Merseyside

Over the last 7 days, there has been over 1,100 individuals living in Wrexham + Flintshire testing positive for COVID-19. pic.twitter.com/rc5j8YSlw4

— Betsi Cadwaladr (@BetsiCadwaladr) December 24, 2020

A report on the current state of the Welsh NHS has been published by Health Minister Vaughan Gething to illustrate the scale of the pressures being faced.

It shows that just under one in ten beds in North Wales (9.5%) were occupied by Covid-19 patients as of mid-December, compared to an all-Wales figure of 33.5%.

Almost half of acute hospital beds in the Cwm Taf Morgannwg area, which covers Bridgend, Merthyr Tydfil and Rhondda Cynon Taf, are filled with coronavirus patients (48.2%).

However, 76.4% of A&E patients were still seen within the four hour wait target last month.

Mr Gething told Senedd Members that staff sickness had also contributed to longer waits.

In a statement, he said: “We are seeing demand for health and care services continuing to increase, at a time when capacity is constrained by physical distancing requirements and staff sickness absence.

“Health and care staff have worked incredibly hard to keep us all safe over the past nine months, often at great cost to their own health, wellbeing and time spent with family and loved ones.

“I am tremendously grateful to our staff for continuing to show such commitment and compassion to keep all of us safe.

“There is no indication that the pressures on the system are likely to ease as we see significant increases in the incidence of Covid-19 in our hospitals and communities, which will be compounded by the same types of challenges we would expect to see over a ‘normal’ winter.

“It is absolutely vital, in this context, that we all play our part in helping to slow the spread of coronavirus and protect our NHS this winter by follow the advice and reduce social mixing to a minimum. We can all make a difference and help to keep Wales safe.”