FEARS are now growing the NHS is on the eve of a winter crisis as the impact of Christmas and New Year hits.

Hospitals have been coming under increased pressure as they deal with a surge in demand from patients while struggling to get others discharged quickly enough to make room for them.

The Royal Sussex County Hospital in Brighton has been operating at the highest level of alert, black status, although yesterday this had been downgraded.

Some patients were diverted to the Royal Sussex’s sister hospital, the Princess Royal in Haywards Heath to help ease the pressure in Brighton.

Last week Worthing Hospital also briefly ran at black alert following reports after becoming “very busy” and this led to some appointments and procedures being postponed.

Concerns are now being raised about the ability of hospitals in Sussex to cope after the Christmas and New Year period, when there is a traditional increase in patient numbers.

A spokesman for the Patient Action Group said: “It feels like hospitals are now struggling all year.

“Although staff do their best in really difficult situations, we do fear things are on the edge at the moment and it would not take a lot to tip over.”

A Brighton and Sussex University Hospitals spokesman said: “As with many hospitals across the country, the emergency department at the Royal Sussex is currently busy and the staff are working hard to give patients the emergency care they need.

“We ask the public to use A&E appropriately and to use the many alternative services available if they do not require emergency treatment.

“This allows our emergency teams to treat the significant number of very sick patients, as quickly as possible.

“There is a clear plan to increase capacity over the next four months to address the expected increased demands over the winter period.

“Critical care is reviewed on a daily basis to ensure there is always capacity to manage our sickest patients and we are working closely with system partners to continue to improve patient flow through our hospitals.”

A large part of the problem is the difficulty in discharging patients who are ready to go home but need to wait for a nursing or care home bed to become available in the community or for a package of care to be arranged for them in their own homes.

Cuts in government funding for adult social care across Sussex are also having an impact.

Earlier this week West Sussex County Council called on the government to tackle the crisis and take decisive action to help struggling social care services.

Backlogs in A&E departments caused by a shortage of available beds also leads to delays for ambulance staff waiting to hand over patients they have brought in because hospital staff are too busy.

A South East Coast Ambulance Service spokesman said: “We will continue to work closely with all hospitals across our region to ensure patients can be handed over as quickly as possible so that our crews are available to respond to patients in the community.”

A&E DOORS NEVER CLOSE BUT ONLY VISIT THE UNIT IF IT’S VITAL

NHS services traditionally come under extra pressure in early January as GP practices reopen after bank holidays and people who have put off getting treatment start making appointments or head to A&E.

The colder weather also puts the elderly and frail more at risk and because they often have complex problems, they can end up staying in hospital for longer than average.

However, this year the pressure is already being felt before the festive season kicks off, sparking concerns about the ability of already extremely busy hospitals and services to be able to cope.

Accident and emergency departments are the most high-profile casualties, as a surge in demand combined with a shortage of beds can lead to long waits of 12 hours or more.

Ambulance crews also struggle as they are left waiting to hand over patients they have brought in to A&E staff.

These delays means fewer ambulances are out on the roads to respond to emergencies, meaning patients could be put at risk because they wait to too long for paramedics to arrive and get them to hospital.

Also extra beds are opened, they are being filled very quickly and the patients just still keep coming in.

One of the main problems is the availability of care and nursing home beds in the community where patients well enough to leave an acute hospital can get extra support.

The shortage of these around the county and delays means a rise in the number of what are known as bed-blocking patients – those who should be out of hospital getting help but have nowhere to go.

Other issues have included the time it can take to arrange a package of care for people in their own homes following a stay in hospital.

Cuts in government funding for adult and social care services across Sussex and the rest of the country has also added to the pressures at a time when people are living longer and demand for support rises.

For example, there are currently about 2,850 people aged 65 and over in Brighton and Hove who have dementia but this is expected to reach 3,892 by 2030.

West Sussex County Council recently called on the government to set up a task force to tackle the adult social care crisis.

The council will spend £296 million – 36 per cent of its entire budget – next year on adult social care services, to meet the increasing demand for care.

Council leader Louise Goldsmith is writing to the Secretary of State for Communities and Local Government Sajid Javid to raise the council’s serious concerns and call for national leadership to address the long-term issues.

Work has been done by clinical commissioning groups and local councils to help tackle the problems faced.

A spokesman for Brighton and Hove City Council said: “The council’s adult social care staff are working with the NHS to support people to get home from hospital quickly with the necessary support and assessments.

“Where possible, the council is assessing people’s care and support needs in their own homes, avoiding prolonged stays in hospital beds.

“The feedback from patients and their families has been overwhelmingly positive so far.

“Social workers will be hard at work at the hospital each and every day, including Christmas, to provide patients and their families with the support they need.”

The East Sussex Better Together programme was set up to get health and social care services working more closely together in a bid to prevent people having to come into hospital in the first place.

New services launched include nurse-led crisis response teams which provide urgent assessment and community nursing care in people’s own homes.

A spokesman for the Eastbourne, Seaford and Hailsham and Hastings and Rother clinical commissioning groups (CCGs) said: “Patients cared for at home will have a suitable care plan initiated for up to 72 hours.

“After this time, further assessment and support can be arranged as necessary to ensure the patient can remain safely in their home.

“This enables people to be cared for in a familiar environment without the added stress and anxiety of being admitted to hospital – providing the right care, in the right place, at the right time.

The two CCGs are also funding a number of extra beds in care homes within their patch, meaning patients can be discharged from hospital more quickly.

Western Sussex Hospitals NHS Foundation Trust, which runs hospitals in Worthing, Chichester and Shoreham, says being able to discharge patients was vital.

Medical director George Findlay said: “Christmas is always busy for our specialist staff who continue to work around clock caring for people and helping patients leave hospital once it is safe for them to do so.

“We are therefore very grateful to families who work with us to help their loved ones back home, or on to a more appropriate care setting.

“Our doors never close, but it is very important that people only attend A&E, or stay in hospital for as long as is absolutely necessary, if we are to successfully meet the increased demand for our services at this time of year. I must stress, however, that if you do require urgent medical attention you should never delay calling NHS 111, your GP, or 999 in an emergency, for advice or assistance.”

A&E ALTERNATIVES AVAILABLE TO PATIENTS

PEOPLE are being urged to consider alternatives to A&E departments over the Christmas and New Year period and beyond.

This will help ease pressures on the departments so they can deal with genuine emergencies such as heart attacks, strokes, unconsciousness and difficulties breathing.

Using alternatives will also mean shorter waits for patients with minor problems because emergency and urgent cases will always take priority.

Options include the walk-in centre next to Brighton Station, which can deal with a whole range of minor injuries and problems including cuts and grazes, minor scalds and burns, bites and stings, dressings, minor eye conditions and infections and coughs, colds and flu-like symptoms.

Minor injuries units are also based at Lewes Victoria Hospital, Uckfield Community Hospital and Crowborough War Memorial Hospital.

In West Sussex there are minor injury units at Horsham Hospital, Bognor War Memorial Hospital and the Park Surgery in Littlehampton.

There is also an urgent care centre at Crawley Hospital which can deal with issues such as sprains and strains, broken bones, minor burns and scalds and minor head and eye injuries, Pharmacists can also provide help and advice and out-of-hours services are offered by GPs for those who need it.

People can also call the NHS 111 line for advice and information.