Help us to help you: Devon’s health and care system under extreme pressure

The Devon health and social care system is under extreme pressure due to high demand for services and the number of staff and patients affected by Covid-19. 

As a result, people are facing longer waits in emergency departments and planned procedures are being postponed. 

The NHS is asking the public to help by using services wisely and doing their bit to reduce the spread of Covid-19.

On 25 August across Devon:

• 127 beds were occupied by Covid patients
• 14 of those were in high dependency or intensive care units
• 7 were on mechanical ventilation
• 713 staff were off due to Covid-19, amounting to 32% of all absences

Pressures are being seen across the system, in mental health care, primary care (GPs) and adult social care as well as our acute hospital trusts.  

NHS Devon Clinical Commissioning Group Clinical Chair Dr Paul Johnson said: “Our staff have been working tirelessly throughout the pandemic. They are extremely tired and we need you to support them and us by getting vaccinated, using our services wisely, maintaining social distancing and picking up your friends and family promptly when they are ready to leave hospital.”

Factors causing the pressures include:

• Higher numbers of Covid inpatients. Although numbers are lower than previous waves, there is a significant impact on beds and staffing available for other patients including those who are due to undergo planned procedures
• High Covid rates – we have high levels of staff isolating because they or a family member has Covid-19.  This is making it harder to maintain services at a time when more staff are taking much needed and well-earned annual leave.
• High numbers of people attending emergency departments (ED) – many of these patients are very unwell and need to be admitted into hospital beds.
• Patients using ED inappropriately. People who have an emergency should attend ED but those who attend for treatment for minor conditions will have a very long wait and are putting unnecessary pressure on these already stretched services. Only use an emergency department as a last resort – see below
• Delays in discharging people from hospital. Covid pressures are impacting on social care providers’ ability to deliver their services, meaning that care packages in the community are difficult to resource. This means that there are many people in hospital who are ready to leave, consequently we can’t use their beds for patients who are waiting in ED.
• Job vacancies – There are vacancies across the health and care system. For example we need at least 1,000 more social care workers locally and there currently 1,400 NHS vacancies in Devon.
• Demand for NHS 111 is up to 12% higher than expected on some days

Primary Care:

Primary care is the NHS’ front door, and the level of demand for GP services shows no sign of abating. Over the last year, there have been millions of face to face appointments in general practice in Devon, and our GP practices have seen a 14 per cent increase in demand since before the pandemic.

This sheer volume of calls has resulted in GPs and nurses working through long lists of requests to call people back. More and more people are contacting their GP surgery for home visits or if they need help for their mental health. 

While GPs have continued to provide face to face appointments throughout the pandemic for anyone who needs to be seen in person and it's clinically appropriate, the increase in requests has added significant pressure to primary care.

Like many frontline services, GP practices are still suffering the impact of the isolation rules for people who are household contacts of a positive case. Nearly all of our GP practices have been impacted over the last year, and currently 1/10 practices are facing severe operational pressures and the other 9/10 are seriously impacted by the increase in demand and staff isolating. 

What is the NHS doing about it the pressures across the system?

• Staff are working long hours and extra shifts, but they are extremely tired.
• Creating extra capacity. We are building new theatres and diagnostic facilities in Plymouth and at the former NHS Nightingale hospital in Exeter.
• Recruiting more staff. If you are interested in a career in health or social care we would love to hear from you: proudtocaredevon.org.uk
• Promoting how to access health care services through local media and our social media channels.
• Vaccinating people – the local vaccination programme continues at full steam and is saving lives every day.
• Asking local people to do their bit by choosing the right service for their needs and being patient where needed.

We need your help – here’s what you can do to support your local services:

• Keep the Emergency Department (Accident and Emergency) for emergencies. If your condition isn’t an emergency, choose a different service. You may have to be prepared to wait a bit longer for treatment if it isn’t urgent.
• Use your local pharmacist for minor conditions such as insect bites, ear ache, skin rashes.
• Use the HANDi paediatric app for advice on common childhood illnesses
• Use NHS 111 – online or by phone if you need advice or medical treatment quickly and can’t wait to see your GP. If you need to be seen by a Minor Injuries or Emergency Department they can book you in.
• Get vaccinated. Have both jabs if you are over 17 and 9 months.
• Case rates in the south west are among the highest in the country, the virus is still very much here so please continue to maintain social distancing and good hygiene, especially hand hygiene, to reduce the spread of Covid-19. Meet outside where possible
• Collect friends or family members from hospital as soon as possible when they are ready to leave. It means their bed can be given to someone who needs it.