STAFF at Hereford County Hospital have been saluted for coping with “unprecedented pressure” over the past week.

 The hospital will stay at critical incident status until next week.

This afternoon, Wye Valley NHS Trust chief executive Richard Beeken said hospital staff had been “going the extra mile” throughout Christmas-New Year – and particularly the past week – to handle record demand that shows little sign of easing.

An A&E designed to handle no more than 125 patients a day is regularly seeing 150 while bed availability has a maximum of 220.

On one day this week the hospital took 57 emergency admissions all described as “extremely sick” and in need of urgent care.

“Thanks to the expertise, care and skill shown by our staff members, we were able to free up enough beds to ensure these patients received safe and compassionate care,” said Mr Beeken.

Hospital bosses are meeting several times a day to carefully plan which beds are being used and which patients can be discharged - often with a package of care to ensure they are discharged safely to their own home.

At one point, the pressure was so acute that the hospital had nearly 50 patients in A&E, five waiting on trolleys to be seen, a full Clinical Assessment Unit, a full discharge area, and a single resuscitation bay free.

“We have worked hard to ensure we make use of the beds in our community hospitals and have been caring for patients at these to free up beds at the County Hospital.

“I’ve seen team-working like never before and I’ve seen staff go well beyond the call of duty. I’d like to publicly thank every member of Trust staff, from the doctors and nurses on the frontline right through the organisation to those who work in the back offices - those that patients never see - it’s thanks to their professionalism and willingness to go the extra mile that our patients have had the best experience possible while in our care,” said Mr Beeken.

Throughout the week staff who would otherwise be working in back offices, but have a clinical or medical background, have volunteered to help their colleagues in the Emergency Department.

Partner organisations in the county who had pulled out all the stops to help with the surge in demand for services - particularly Herefordshire Council’s social services teams helping ensure patients could be discharged safely to their homes to free up beds.

But many routine operations have had to be cancelled.

The Trust declared a “critical internal incident” on Monday this week, January 5, due to the unprecedented pressures on its services. This allowed the Trust to redeploy staff and cancel operations to ensure it could safely care for those needing urgent care and treatment.

Figures published this week by the Department of Health showed that during the last three months of 2014, 85 per cent of people attending the Emergency Department were seen within four hours - the national target is 95 per cent.

During the Christmas and New Year period, this figure fell to 74 per cent due to the increase in patients.

“We are not out of the woods yet and we are still experiencing huge pressures, so our advice remains that people should only visit A&E if they need urgent medical care or treatment,” added Richard.

Alternatives include using the NHS 111 advice line, using local GPs, visiting the GP walk-in centre in Hereford, using local Minor Injury Units or seeking advice from local pharmacies.

This week, Mr Beeken told the Hereford Times he was ready to make the “critical” call over Christmas and New Year, but held off until other agencies were in a position to assist the hospital with unprecedented urgent care demand.

Senior medical staff at the hospital – put into special measures in October - are pressing for “critical incident”

status to continue to clear the backlog of patients, admissions and operations.

On Monday, when the critical incident call was eventually made, 135 patients attended A&E and 57 emergency admissions accepted.

By then, demand levels described as “unceasing and unprecedented” had taken the hospital to a “level 4”

alert – the point at which demand exceeds capacity by 30 to 40 per cent.

Daily attendances at A&E topped 164 over Christmas- New Year.

The trust has the power to declare an internal incident if it feels pressures in A&E present a serious threat to the disruption of its services.

Critical incident status means:

-  Staff leave and training leave cancelled with support brought in from the trust’s staff bank, agencies, and volunteers for extra shifts.

- The cancellation of routine outpatients appointments to release consultants to urgent care.

- Elective surgery areas adapted for A&E assessment.

- A control room maintained as a situation management centre.

- Assistance sought from the Clinical Commissioning Group and Herefordshire Council from extra GPs to the faster confirmation of care packages allowing patients to be discharged.

Extra ambulance space has also been found with turnaround a major issue as emergency vehicles wait with patients while blue light calls come in.

At one point on Tuesday afternoon, seven ambulances - almost the entire fleet available to the county at the time - were waiting outside A&E to admit patients.

As yet, West Midlands Ambulance Service has not been asked to divert incoming patients away from Hereford A&E.