Lancaster hospital at high alert level for ‘unprecedented’ A&E demand

A Lancaster hospital has announced that it has seen “increased pressures” caused by a high level of A&E visits in recent weeks.

Royal Lancaster Infirmary (RLI) saw 1,391 attendees at its Emergency Department in the week beginning 25th November, the highest number on record.

The hospital has escalated to a high level, level three, of the Operations Pressure Escalation Levels (OPEL), which is used by the NHS to “measure the stress, demand and pressure a hospital is under.”

The hospital first escalated to OPEL four on the 3d December, before dropping down to OPEL three on 5th November.

The change to OPEL four was announced by University Hospitals of Morecambe Bay Trust (UHMBT), which runs RLI, on its website.

OPEL four is declared when a hospital cannot “deliver comprehensive care” and patient safety is compromised, according to the NHS OPEL framework.

When the hospital was moved to OPEL three, the trust said that the previously stated risks are “still significant,” however they do not currently match the OPEL four framework.

In their original statement, the trust said that Royal Lancaster Infirmary’s Emergency Department had seen 80 patients on 2nd and 3rd December, which it stated was “not a safe situation.”

The demand led to ambulances having to queue outside the Emergency Department, which the trust said compromises “the ability of ambulances to respond to life-threatening emergencies in the community.”

Around the time of this news, it was also announced by the NHS that a new site near Lancaster University will potentially replace Royal Lancaster Infirmary.

The proposed Bailrigg East site would be situated north of campus, and planned development is a part of the New Hospitals Programme.

Final decisions will be made on the new proposed site after “formal public consultation.”

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In the meantime, Royal Lancaster Infirmary will continue to operate as normal.

University of Morecambe Bay Hospital Trust has shared the immediate actions being taken by its teams and the trust’s partners, which include using alternative departments to the Emergency Department and cancelling non-essential meetings to focus clinician time on “patient facing activities.”

Community colleagues are also focusing on “admission avoidance tactics.”

“The safety of our patients is vital,” the trust said, “and the decision to declare OPEL four acknowledge[d] that we were at a point where we cannot continue in the way we are due to the increased risk of harm.”

The trust are further looking for support from “local place-based partners” and Integrated Care Board systems.

Integrated Care Boards are NHS organisations that plan health services for the local population.

In the trust’s full statement when Royal Lancaster Infirmary reduced to OPEL three, the trust said: “While University Hospitals of Morecambe Bay NHS Foundation Trust remains under pressure, the Trust has taken the decision to de-escalate back to Operations Pressure Escalation Level (OPEL) 3. This decision was made because the pressure at the Royal Lancaster Infirmary has reduced to a level which, while still significant, does not meet the national OPEL 4 criteria.

“We would like to thank the public for their patience and understanding, and our staff who have been under significant pressure during this period.”

The trust has asked that the public continues to turn up for appointments as usual, unless contacted directly to state otherwise. It asks that patients who are unable to attend appointments contact the phone number on their appointment letter, so their appointment can be reallocated.

It also asked the public to only attend A&E for “serious accidents and emergencies” and ensure they are using the correct hospital services for their needs.

For non-emergencies, the public can visit NHS 111 online for 24/7 advice on the types of care their needs require.

Royal Lancaster Infirmary and University Hospitals of Morecambe Bay NHS Trust have been contacted for comment but have not yet responded.