Harrogate District Hospital has the capacity to increase its number of beds by 50 as part of winter escalation plans.

Dr Matt Shepherd, deputy chief operating officer and consultant in emergency medicine at Harrogate and District NHS Foundation Trust, revealed the numbers in an interview with the Stray Ferret yesterday.

Talking about the trust’s winter plans, Dr Shepherd said the hospital currently has 260 beds, 20 more than in summer, and has the potential to increase this to 310. Ripon Community Hospital has the capacity to increase beds from 16 to 20.

The hospital covid situation remains considerably better than last winter, when the number of patients in Harrogate with coronavirus peaked at 70, and during the first wave in spring last year, when the figure was about 40.  He said:

“Up to four or five weeks ago we had on average four or five patients with covid, then it crept up to 10 and then a couple of weeks ago it went up to 20. It’s trickled down in the last few days to 15.”

The Harrogate district currently has one of the highest covid rates in the country, with the seven-day rate currently 727 per 100,000 people.

But he pointed out that this time last year the hospital had cancelled many other services due to covid and this time staff were heading into winter dealing with coronavirus “on top of other things”.

‘Big impact’ of vaccines 

How worried is he about the months ahead?

“It’s a bit like when covid first arrived. It’s that fear of the unknown. Your imagination runs wild with worst case scenarios, which could be very difficult.

“But the vaccine programme has had a big impact. We are seeing far fewer covid patients in intensive care.”

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The hospital currently has eight beds in intensive care and four are being used. Last winter it had to increase the number from eight to 30 to cope.

After two previous waves of covid, the trust now has well rehearsed ‘flex’ plans to cope with fluctuating coronavirus patient numbers. Dr Shepherd said:

“We currently have half a ward devoted to covid patients. When we get to the mid-20s we convert a full 30-bed ward.”

Waiting list increase

He expects extra patients with other respiratory viruses this year because people are mixing more.

It spells difficult times ahead for staff, particularly as the district’s high infection rate has forced a lot of staff to isolate.

Like other NHS organisations, the trust is also dealing with recruitment problems. Dr Shepherd says shortages are often specific to certain areas, such as theatre staff and nurses.

It doesn’t sound like a good time for any of the trust’s 4,000 staff to put in requests for a fortnight in Lanzarote over Christmas. Dr Shepherd says:

“It’s the relentless nature of the last year and a half. The chances of proper rest haven’t been the same. Staff having to isolate is one of the biggest challenges now.”

The impact of lockdown is still being felt. The trust waiting list was 18,000 pre-covid. Now it’s 22,000. Dr Shepherd says the situation varies from department to department.

“There’s been good progress in some areas, for example scans, where we’ve really caught up and there is no real backlog. Also endoscopy.

“But some of the more complex operations take much longer to do and patients are still waiting much longer than they have done in the past in Harrogate and much longer than I would like. We are a small hospital and there are only so many operating theatres.”

Pressure on the emergency department has increased significantly, with most people now seen and either admitted or discharged within six hours rather than four.

Masks and vaccines enough for now

Medical organisations, including the British Medical Association, have said this week it’s time for the government to adopt winter planning now to prevent the NHS being overwhelmed by growing numbers of coronavirus cases.

Dr Shepherd says Harrogate and Ripon hospitals have “never stepped away from asking people to wear masks”.

Does he think it’s time for other measures?

“It’s important that we inform the public that infection rates are higher in the Harrogate district and the best thing they can do is attend vaccination clinics.

“Masks and vaccines are the first next step. If that’s not enough and we continue to see a rise we need to consider a more mandatory position.”