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Working around the clock to look after patients as winter bites

Published 11/02/2013

David Ainsworth is the general manager for acute medicine at Derby's hospitals. Here, he gives an insight into how hospital staff coped with the snowy conditions on Monday 21 January 2013.

8am: We need to take a decision on non-urgent ambulance journeys. We'll have many outpatient clinics whose patients will arrive by an ambulance. There is a risk to ambulance staff and roads are slow. We decide to deal with each patient on a case-by-case basis and to continue as normal until crews tell us they cannot get safely to the patients address. We'll send a communication out to clinics, asking them to be flexible around patients arriving late due to weather conditions.

9am: Staff are still arriving into work, delayed by the slow traffic on our roads. The main entrance has extra volunteers helping people find where they are going to ease their worries of arriving late. Additional cleaners are mopping the drips from the floors to prevent slips and trips. There's a porter pushing a trolley of hospital notes into clinic, evidence the hospital is carrying on regardless.

9.15am: Transport ring to say they are struggling to collect a patient from Stanton. They call and let the patient know and we can rearrange their appointment. We'll be giving priority to kidney dialysis patients and anyone coming for cancer treatments like radiotherapy.

9.50am: A&E is coping, only 12 patients - none of which are with weather-related problems.

10.20am: I pass a patient being wheeled to theatre for their operation. Another sign it's business as usual.

10.30am: Some patients are refusing to travel in for their outpatient appointments due to the weather conditions. One gentleman offered to slide his wheelchair down a hill to get to the ambulance at the bottom of his street. The crew felt this was a little dangerous, so we're rebooking his appointment.

10.35am: A team from the hospital meet with social services to plan the patients being discharged home today and this week.

11am: There are now 31 patients in A&E.

11.20am: I speak live on Radio Derby, reassuring patients its business as usual and they can still come and expect to be seen as clinics are running as planned. I also reminded people to choose well by using alternatives to A&E -such as the walk in centre, 111 and their own GP.

12.15pm: We've just finished the midday meeting to review how we are coping across the hospital. The Trust is on amber alert, which means there are no major concerns. A few more light flakes of snow fall.

12.20pm: The Met Office has sent us a severe weather warning: "Icy conditions are expected to be widespread with some freezing fog also likely to become more prevalent.”

12.25pm: Outpatient clinics are finishing this morning's appointments. They've done really well and most patients have made it to their appointment. A&E has got busy with 50 patients now. We're seeing more slips and falls in the snow and, as expected, broken bones are the main feature for many of our patients.

12.28pm: A hospital car park attendant says people have been driving sensibly on the internal roads around the hospital site.

12.30pm: The orthopaedic team have come down to help in A&E deal with difficult broken bones which may need operations to repair them.

1pm: Our clinics in outpatients are starting work for the afternoon and it looks as though patients are getting here safely.

1.30pm: It's clear the weather is having an impact on people having accidents. The minor injury unit in Ilkeston, and the walk in centre in Osmaston Road are sending patients to us for specialist opinion and treatment.

2pm: A&E is getting busy; we have 65 patients in the department. Broken down, that's 16 in the majors’ trolley area, four patients in our resuscitation room; seven just arrived at the main entrance by ambulance and 18 patients in the minor injury area.

2.05pm: A&E is caring for a number of older people suffering respiratory breathing problems. Colder weather clearly affects people's underlying medical conditions. Keep warm, keep well.

2.08pm: I've just been speaking to a lady in the corridor who is sat waiting for her daughter to fetch a wheelchair. She's wearing five layers, has a scarf and gloves and a tartan blanket......well done, great thinking.

2.15pm: A gentleman arrives in the fracture clinic after his fall in the snow this weekend. His fractured ankle is in a plaster and he's here to see the orthopaedic specialist. He's facing four weeks in plaster and hoping to avoid an operation to repair the bone deformity.

2.20pm: We are filling our beds in the hospital with poorly patients who need to stay in for treatment and further stablisation. The medical assessment unit is expecting six patients after their GP’s referred them in for admission, following home visits.

3.05pm: The volunteers provide an excellent support to the busy hospital. Their three buggies have been busy fetching and carrying people inside the hospital corridors to their appointments. A big well done and thank you to all our hospital volunteers.

3.10pm: Remember A&E is for accidents and emergencies, not anything and everything. If you have a dental problem, there are emergency dentists available. Dial 111 or visit the NHS Choices website.

3.20pm: Four ambulances have arrived in A&E since 3pm and we are expecting a further three in the next five minutes. The Royal Derby Hospital works closely with East Midlands Ambulance Service, which tells us when ambulances are in-bound. It's helpful for us to plan our resources and improves communication.

4pm: We've just finished our bed meeting. It's looking busy across the hospital. We're expecting 13 patients from GP home visits into our medical assessment unit.

5pm: Rounding off the blog. It's been busy across the hospital. Staff and patients have done really well getting into work and arriving on time for their appointments. A&E has seen over 180 patients since midnight. They've coped with their usual daily pressures of dealing with the most sickest of patients to the most minor. 

Last Modified 11/02/2013