Date of publication: 8 January 2026
Hello everyone.
My name's Michael. I'm one of our Consultants in Emergency Medicine and Deputy Chief Medical Officers for the Trust.
I want to take a few minutes today to update you on the current situation we're seeing across both the hospital sites.
We're operating at OPEL 4 today, which is the highest level of escalation we use. It means that the demand for our services is significantly exceeding our capacity, and we're particularly seeing this across our Urgent and Emergency Care streams.
And this does mean that some of our patients, and naturally their families, are seeing long waits for their assessment and treatment within the Emergency Departments and assessment areas. And we recognise how worrying and how distressing that can be for the patients we want to care for.
We also recognise that this degree of pressure has an impact on our staff and that working in these conditions is stressful, it feels relentless, and we have to openly acknowledge that impact it's having on us.
The situation we're in, the situation we're facing, is not through the lack of effort and the fact that the staff are finding it stressful and they're finding it distressing is actually a sign of the dedication, the compassion that we still feel we want to show for our patients. And we're seeing that professionalism and the hard work by all of our teams across the organisation every single day.
We expect winter pressures. We expect it to be busy at this time of year, but what we're experiencing at the moment is exceptionally high and sustained levels of escalation. And that simply requires a high and exceptional and coordinated response from everyone in the Trust.
We've stepped up our Executive-led Gold Command, so providing a very, very senior level of oversight, decision making coordination for everything that we're doing across the organisation. And in turn, we're asking that every team, clinical, corporate, support services, everyone who works within the Trust plays their part in reducing delays to the patients at every stage of their journey through an emergency stay.
Specifically, we have some actions being taken at ward level, and we're asking our Matrons, Consultant Therapists and Service Managers to work closely alongside the Ward Medical and Nursing teams to think about safe alternatives to inpatient care.
We often default to assuming that being in hospital is the safest option for patients, but we know this isn't always the right choice either for the individual patient or for the overall pressures on our systems. So wherever it is appropriate, we need to be identifying the patient to suitable for community pathways. Think about use of our virtual wards, hot clinics, enhanced community services and other out of hospital solutions that help assist safely manage the patients who absolutely need to be in the hospital beds.
As a part of this, we do ask that all inpatients with a NEWS score of less than four - have a fresh look today to think about whether they are suitable for being looked after in a setting other than a hospital bed. Can we use a community service, one of our outreach services to look after them? And the earlier these decisions can be made in the day, the better able we are to support that.
If as a result of this, we need to escalate and get additional support for community care or care packages, please do make sure this is escalated.
We're asking senior colleagues to work some additional sessions to in reach into the Emergency Department to make sure patients get the specialist assessment by the appropriate team as early as possible and to make sure we identify them to go to the right place of care as soon as we can within their journey.
We're asking our Support Services to work very closely with our Clinical teams to make sure that diagnostics, transport, pharmacy, discharge planning, and all these other key elements in patient care are happening at the right time, in the right priority order to get patients better and to get them home.
These are all vital parts in getting patients through the system smoothly, safely, and decompressing our system.
In the face of all this pressure, I also want to emphasise how important it's that everyone takes their breaks as well. It's hard work. We're working at high levels of escalation continuously, but the solution to that is not to run continuously and not to have those pauses. Breaks are important to help us think clearly, function effectively, and to have sustainable working patterns that people aren't making themselves unwell and going off work.
So safe, high quantity care, and looking after ourselves. It is important. We also take the downtime within the shifts and between shifts.
Our focus collectively is on patient safety, dignity, and flow through the system, alongside looking after and caring for each other.
Please do escalate any concerns early on to your seniors, support your colleagues and focus on everything that we can do within our individual roles that can make a difference to patient care.
Thank you, as ever, for everything that has been done that you're continuing to do, to look after each other and to look after our patients.
