By Ian Dipple Thursday 05 December 2013 Updated: 06/12 11:23
SCHEMES to stop people in Redditch and Bromsgrove being admitted to hospital in an emergency appear to be easing pressure on the Alexandra Hospital's A&E department.
But concerns have been raised about the performance of the Worcestershire Royal which is struggling with rising demand, which this week saw it put on level four escalation - the highest rating - meaning urgent help was needed from the rest of the county's health system to ensure it could cope.
The Royal has not hit the four hour waiting time target for five months, while the Alex has exceeded it every month since June.
Since April 34,279 people have attended A&E at the Alex, with 1,960 of them waiting more than four hours and 9,807 being admitted. Over the same period the Worcestershire Royal has seen 40,677 people, with 11,525 being admitted through A&E and 3,277 people not seen within the target time.
Bed occupancy levels at the Alex are also running at 85 per cent, the recommended level, while the Royal's are running about 92 per cent.
Health bosses say there are number of factors as to why the Royal is struggling including the south of the county having a frailer, older population with more complex conditions requiring more time in hospital. It also has a number of beds, such as those for stroke patients, which are ring-fenced and it is a busier site. The Trust also closed 28 beds at each of the two hospitals because commissioners expected emergency demand to reduce faster than it has.
When questioned about the Royal's poor performance at a board meeting last week, chief operating officer Stewart Messer also suggested one of the many factors was schemes put in place in Redditch and Bromsgrove to avoid hospital admissions appeared to be having more of an impact.
"We've got GPs within hospital working with acute and emergency department physicians to try and avoid admissions and they've also expanded their virtual ward in Redditch and Bromsgrove," he said.
"It may be South Worcestershire have got some lessons to learn from Redditch and Bromsgrove in that respect."
South Worcestershire CCG do not have a virtual ward - which creates and delivers treatment normally given in hospital in the community. It has introduced many other schemes though including GPs in the back of ambulances which since October last year has stopped 1,221 people being taken to hospital.
Simon Trickett, South Worcestershire CCG's chief operating officer, said attendances in Worcester were down two per cent on last year and emergency admissions directly by GPs were down eight per cent but he acknowledged there had only been a slight reduction in admissions through A&E itself.
He said admission prevention schemes continued to be monitored and improvements made but added: " It’s also important to understand patients from across all the county access the Worcestershire Royal Hospital and reducing admissions is a challenge that all CCGs are working together to address."
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