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Revealed: Four trusts report quarter of all ‘critical incidents’

Published on: 25 Oct 2023

More than a quarter of ‘critical incidents’ have been declared by just four trusts since the start of the crisis in urgent and emergency care.

Data obtained by HSJ shows 241 critical incidents have been declared by organisations due to “operational” or “system pressures” between April 2021, when long waits for urgent care began to surge upwards, and last month. Four trusts account for 68 of these, or 28 per cent.

University Hospitals Plymouth and Shrewsbury and Telford Hospitals had the most, declaring 24 and 21 incidents respectively due to operational pressure.

Frimley Health and United Lincolnshire have also respectively declared 12 and 11 incidents due to pressures. Frimley has had issues with the installation of a new electronic patient record in recent years. These organisations did not respond to requests for comment.

Critical incidents are declared when the level of disruption “results in an organisation temporarily or permanently losing its ability to deliver critical services, or where patients and staff may be at risk of harm”. These incidents may require “special measures and support from other agencies, to restore normal operating functions,” according to the NHS England definition. 

Most critical incidents were only in place for a few days before being stood down by the trust or system, but some were in place for much longer – sometimes for several months at a time, the data suggests.

Last December, 97 organisations declared critical incidents due to operational pressures – a significant increase on previous months.

The full list of organisations to have declared a critical incident is below.

Small proportion of critical incidents ‘caused by strikes’

Last month, health and social care secretary Steve Barclay said 22 “critical incidents” that had been “declared due to industrial action” since last December – as part of his justification for proposed “minimum service levels” during strikes.

Between December 2022 and October 2023, a total of 141 “critical incidents” were declared by trusts and systems due to “operational” or “system” pressures – up from 75 incidents during the same period the previous year.

Sarah Scobie, Nuffield Trust’s acting director of research, said the data suggests the number of critical incidents directly attributed to industrial action “are small in proportion to the number of incidents declared because hospital and emergency care services are stretched beyond their limits”.

The Department of Health and Social Care did not comment directly on HSJ’ s findings but pointed to “record” investment in increasing access to care and cutting waiting lists. Mr Barclay has said the proposed minimum service levels “would provide a safety net for trusts and an assurance to the public that vital health services will be there when they need them”.