Four North West hospitals declare critical incidents due to overwhelming demand in A&E

Just a day after the Royal Liverpool Hospital declared a critical incident three other Hospitals have now followed, due to the "very high levels of demand in Accident and Emergency, with rising levels of ill health caused by the colder weather."

A spokesperson for NHS Cheshire and Merseyside said: "As a result of these pressures, the following hospital sites have taken the decision to escalate to a critical incident, enabling them to take additional steps to maintain safe services for patients and help them cope with the growing pressures."

• Arrowe Park Hospital

• Royal Liverpool

• Aintree Hospital

• Whiston Hospital

The Chief Medical Officer at the University Hospitals of Liverpool Group said while patients are being seen "immediately" within the A&E department, the pressures meant some were then having to wait "a long time" to be placed on a ward.

Some patients reported waiting up to 50 hours on trolleys in corridors for a bed.

Meanwhile, there are warnings from a Liverpool GP that a referral to hospital is a sentence to 24 hours in a waiting room.

Annie Farrell said: "We might see a patient either in their own home or if they've come to the surgery and we feel they may be really, really unwell, maybe they need to go into hospital for investigations or for treatment. But we know that by doing that we are literally sentencing them to 30 or more hours sat on a plastic chair or on a trolley in a corridor.

"It's something that we just have to really bear in mind and run past the patient and their family before we consider whether sending them to hospital is the right thing to do."

The Royal Preston Hospital could be the next to declare a critical incident. A consultant working in the emergency department has described the "very very high level of pressure" as the hospital is "just short of declaring a critical incident".

Dr Michael Stewart said the Accident & Emergency department is currently working at about double its capacity.

Dr Stewart said: "We currently have about 110 patients in the department that is geared up for about half that number. "About 50 of those patients who have been seen and treated need to be admitted to hospital and are currently stuck in the emergency department because the wards are all full.

"While the critically-ill patients are still being seen straight away, the more stable ones are waiting several hours to be seen."

The message from hospitals across the North West is that the emergency departments are open and will always help seriously-ill patients but that people should only attend in an emergency.

At many of the Hospitals including Royal Preston, there are an increased number of people arriving with flu and norovirus symptoms adding to the pressure. Dr Stewart said while most patients are seen in about four or five hours, there are some who need to be admitted that have spent two nights in the emergency department waiting to get on a ward.

Dr Stewart said: "We are seeing increased rates of flu and norovirus and the typical winter infections at the moment, flu cases are still rising it is not as bad as it has been in previous years but it is worse than it was last year.

"At the moment the numbers are still rising and until we see the peak in that it is difficult to see what the impact will be"

There are calls for more medical staff to deal with the increased demand, but Dr Stewart said "at home care" is also needed for patients who are ready to be discharged.

He said: "This morning we had 100 patients in hospital beds who did not have a medical need to be in hospital, but still had some care and support needs, but we couldn't discharge them home because the care did not exist for them at home"

Hospital staff are asking for people's help and support as they deal with the situation.