UPDATE: Dozens forced to wait outside A&E in ambulances over Christmas

THE HIGHEST possible alert has been issued at two Oxfordshire A&E departments as hundreds of operations are postponed in a battle against mounting winter pressure.

Paul Brennan, Director of Clinical Services at Oxford University Hospitals NHS Foundation Trust (OUH) confirmed the trust, which runs the John Radcliffe Hospital's and Horton General Hospital's emergency departments, had been operating at Operational Pressure Escalation Level 4 (OPEL 4), formerly known as 'black alert', since Tuesday.

NHS England guidance says OPEL 4 is declared when there is 'increased potential for patient care and safety to be compromised' and 'external extensive support and intervention is required'.

And in the latest available figures, OUH ranked 106 out of 133 trusts in England for waiting times.

Mr Brennan said: “In common with health systems up and down the country, we are experiencing seasonal high volumes of attendances at our emergency departments, in conjunction with difficulties in discharging patients who are medically fit to leave hospital.

"Seasonal flu is also a contributory factor, and we have seen around 100 confirmed inpatient cases since November."

Non-urgent, elective procedures such as hip replacements have been postponed at the John Radcliffe Hospital in Headington since December 27 and this was extended yesterday to the Nuffield Orthopaedic Centre and Churchill Hospital.

It is anticipated around 460 procedures will be postponed from now until the end of January, with patients who are affected contacted directly.

Outpatient appointments, day case operations, diagnostic tests, cancer and emergency treatment would continue as normal.

As 'short term measures', six temporary medical beds at the Horton General Hospital have been opened in recent weeks and a further 39 temporary beds will be opened at the John Radcliffe Hospital and Nuffield Orthopaedic Centre this week.

It comes as hospitals in England were told to delay pre-planned operations and routine outpatient appointments until the end of the month due to severe winter pressures.

Based on the latest A&E figures released for Oxford University Hospitals NHS Foundation Trust (OUH), just 82.1 per cent of patients were seen within four hours in November, compared with an average of 88.9 per cent across England and significantly below the government's target of 95 per cent.

The hospital trust ranked 106 out of 133 trusts and was down more than 10 per cent from the same time last year.

In a bid to deal with squeezed resources, OUH was similarly forced to postpone a number of planned, non-urgent operations in November citing an 'unprecedented demand' at both the John Radcliffe Hospital’s and the Horton General Hospital’s emergency departments.

In the same month, concerns were raised about the county's action plan to avoid a crisis in A&E during the winter period, which was unveiled by health chiefs at a Health and Overview Scrutiny Committee meeting.

The plan, also designed to manage pressure on social care, included boosting the number of pharmacists in care homes, making more GP appointments available and taking steps to more quickly decide who actually needs to visit A&E.

Larry Sanders, on behalf of action group Oxfordshire Keep Our NHS Public, however, warned the plans could not plug a lack of funding and patients would suffer.

On the latest recommendations from NHS England, which came following a meeting of the body’s National Emergency Pressures Panel, he said: "It's a disaster nationally and any plan locally, no matter how good, isn't going to be able to change that."

Mr Sanders, who is also the Green Party's spokesman for health and the brother of US senator Bernie Sanders, added: "It's a failing system and I don't blame local hospital bosses because if the money isn't there then it isn't there. I do think they could speak out more strongly about the problems they are facing though."

The influx of patients at local A&Es continued into December, with emergency departments at the John Radcliffe Hospital’s and the Horton General Hospital’s experiencing ‘higher than usual demand’ over December 16,17 and 18, with approximately 800 patients seen.

Rosalind Pearce, Executive Director of watchdog Healthwatch Oxfordshire, said: “If people are having their operations cancelled, Healthwatch would like to hear from them.

"It seems to be an annual event whereby the hospitals can’t cope with the existing demand when A&E puts greater pressure on beds and staff.

"It appears to be something that locally, we can’t work out an answer to.

“Having said that, people are moving out of hospital quicker than they have done in the past, which will free up beds for people coming in through A&E. Part of the answer is to make sure that people only go to A&E if they absolutely need to. They should contact 111 or try and get an appointment with their GP rather than turning up at A&E.”