Concern that "habitual residents" at QA consume a “huge amount of time and resources”

Councillors have raised concerns about “habitual residents” of Queen Alexandra Hospital’s A&E, amid pressures on the emergency department and patient capacity.

Members of Portsmouth City Council’s health, overview and scrutiny panel questioned a report put forward by Portsmouth Hospitals University NHS Trust, which oversees Queen Alexandra Hospital.

The report noted that the hospital’s 12-hour performance “remains significantly challenged”.

Since the last report, published in March, 1,949 patients spent more than 12 hours in the emergency department (ED), against a target of 1,779.

Some 46 per cent of admitted patients spent more than 12 hours in the ED, compared with 2.4 per cent of non-admitted patients.

The hospital has also been dealing with pressures around bed occupancy, partly driven by patients who are medically fit but unable to leave hospital.

Bed occupancy remains a “significant challenge”, with overall occupancy at 109.2 per cent of core bed capacity.

Medical bed occupancy is 114 per cent, an improvement from around 127.9 per cent earlier in the year.

High emergency demand continues to put pressure on ED and inpatient capacity, with overnight escalation areas and corridor care still being used.

Councillor Suzy Horton recounted when she was “trapped in A&E overnight” and said she came away from the experience with some observations.

She said there were a “number of people who were there the whole time who are there regularly”.

She described some of them as apparent “habitual residents of A&E who in my humble opinion seem to have additional needs”.

She added: “It occurred to me where else could they be.”

In response, Juliet Pearce, PHU’s nurse director, said: “There is a disproportionately small number of people who take up a huge amount of time and resources in the ED – they do need support, it’s probably not the right type of support for them.

“As we start to see those patterns we work with our community partners, our mental health partners to look at wrap-around support.”

She said this wrap-around support can result in a “significant reduction for many of those patients in the number of times they attend the ED”.

“We absolutely could do more because the resources that we have are probably not enough to cover the amount of people that can benefit from that service.”

She said the trust is looking at funding and collaborative work to increase the service as “they need support from multiple services, not just health”.