CROWDED A&E, FULL BED BASE The Trust’s Boston, Pilgrim Hospital was experiencing severe flow difficulties, with continued admission growth (a further +6% during this project). Its A&E was cramped, a bottleneck would arise as soon as 8 non-ambulatory patients were present. At which point arriving patients could not be processed - A&E breaches and handover delays commonplace. Patients needed admission to a bed base that was 100% occupied and lacked the short stay beds to medically assess and turnaround patients without longer stay admission. High numbers of outliers persisted with spill over into the elective bed base causing theatre cancellations and waiting lists to build. Staffing beds was also a constant challenge, with heavy dependence on agency and bank. O

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