Hundreds of operations cancelled as Gwent hospitals struggle to cope with unprecedented emergency demand

The recent bouts of freezing weather, allied to an already busy winter and the worst flu season in seven years, have combined to put enormous pressure on the area's acute hospitals. 

More than 850 routine operations have been called off since the end of February, twice the number of cancellations that might be expected during a whole winter. The figures have been revealed as it was announced the Welsh NHS has experienced the busiest winter on record.

Aneurin Bevan University Health Board's chief operating officer Nick Wood said a decision had been made to move away temporarily from treating elective patients, in order to deal with the huge emergency demand.

"We have focused solely on day cases, cancer and very urgent cases in the last three or four weeks," he told health board members.

"We must get the system back into equilibrium, and there will be further reduced elective activity until the end of the year (March 31)."

The health board, like others in Wales, have been implementing plans to cope with predicted annual increases in demand during winter, but all have been struggling to deal with the extra challenges of flu and the recent severe weather.

"We need to learn a lot from this winter. We did not anticipate or predict a 'red' weather event, but our system was already under significant pressure before then," said Mr Wood.

He said that the effects of the winter pressures will be analysed after Easter, and the aim will be to learn lessons early, for next year.

Performance figures for February will be published today and are expected to reflect the difficult winter faced to the end of that month by the NHS in Wales, though not the extreme difficulties of the last three weeks.

Mr Wood said 862 elective operations have been cancelled, almost 500 of which are orthopaedic procedures.

The wave of cancellations means that the health board will fall well short of its March 31 target of reducing to 145 the number of patients who will have waited more than 36 weeks from referral to treatment.

The health board will now seek to deal with the backlog during April-June.

Patients with flu and flu-like symptoms have been seen in emergency departments and assessment units since January, adding to already significant winter pressures, and a further increase in demand in March had been "extremely difficult to manage", said Mr Wood.

The three acute hospitals - the Royal Gwent, Nevill Hall, and Ysbyty Ystrad Fawr - operated at escalation level four, the highest and an indication of extreme pressure, for the first two weeks of March.

And though the situation has eased somewhat at Ysbyty Ystrad Fawr and Nevill Hall, Mr Wood said the Royal Gwent "has remained pretty much at the highest level of escalation since March 1".

He said the biggest issue has been within the medical assessment unit, and with GP assessment numbers, with a particular issue around GP referrals for assessment being that they tend to present after 3pm.

"So the bulge in activity shifts to the evening. This is one of our biggest challenges," said Mr Wood.

Evidence shows that illness among older people rises during periods of very cold weather, and Mr Wood said there have been "higher levels of acuity in the last two weeks".

The Argus reported earlier this week that there were hundreds more A&E attendances - including many more serious cases - through February, with a 12 per cent increase year-on-year in such cases among over-65s.

Mr Wood said the result has been "significant congestion at the 'front door'", resulting in ambulance waits and hundreds of A&E waits of more than 12 hours.

The pressure has also been felt by the Welsh Ambulance Services NHS Trust, which has also been operating at the highest level of escalation, said Mr Wood.

It has recently recorded its highest number of 'red' (immediately life-threatening) calls for the Gwent area, on occasion having taken more than 100 such calls in a day.

Ann Lloyd, who chairs the health board, said the pressure on staff during the winter has been "unrelenting".

"I am very proud of this health board and its staff for maintaining services. The leadership and the staff have done fantastically well," she said.

Meanwhile, figures released today have shown the Welsh NHS has experienced the busiest winter on record.

Health secretary Vaughan Gething said: "Along with record levels of emergency admissions, we’ve seen the highest levels of flu and proportion of elderly patients admitted for many years.

“Despite this sustained pressure the vast majority of patients have received timely, professional care.

"I would like to thank NHS and social care staff and volunteers for their dedication in delivering care during this challenging period."

He added: "The extreme weather has brought with it a spike in respiratory illness, the highest GP consultation rate for flu for seven years and a 13 per cent increase in patients over 75 at A&E compared to the same time last year."

But the Labour health secretary said many performance measures had improved.

“I congratulate the ambulance service for exceeding their national target for red calls for the 29th consecutive month and am pleased to see that delayed transfers of care come down, with 51 less than reported in the January," he said.

"The total for February is one of the lowest on record.

"This has been achieved through the resilience planning put in place by health boards and local authorities.

“However, there have been times this winter when patients have been waiting longer than is acceptable.

"We have been clear with chief executives of health boards about our expectations around quality of care and performance, and will work with them to evaluate improvements taken this winter.”

Mr Gething added the challenges were not unique to Wales, but the Welsh Governement had handed over an extra £20 million in the first two months of this year to help the NHS cope with the pressure and get patients home as quickly as possible.