HOSPITAL bosses have warned that another chaotic winter could be on the cards if plans to keep patients away from their doors fail to deliver results.

Accident and emergency wards were run ragged last winter as unprecedented demand caused months of bed pressures, missed targets and wards packed full of patients waiting for treatment.

The situation got so bad that top emergency doctors from Worcestershire Royal Hospital, in Worcester, told NHS bosses that they could no longer guarantee patient safety – warning of toxic overcrowding, institutional exhaustion and staff frequently operating at the absolute margins of clinical safety.

Avoiding a repeat of such scenes is a top priority for commissioners, who have spent months deciding how £1.3 million of winter funding should be spent.

But with Worcestershire’s winter plan now mapped out and just weeks away from sign-off, concerns have been raised that it may not be up to scratch.

“The consequences of getting this wrong would just be huge,” said trust chairman Harry Turner. “It would be chaotic.”

The plan contains a host of initiatives aimed at reducing the number of admissions to acute hospitals and cutting bed days for patients who do end up on wards. These range from GPs working with ambulance staff to prevent patients going to A&E unnecessarily to extra nursing home beds and more resources for care at home and in the community.

But leading figures at Worcestershire Acute Hospitals NHS Trust are concerned they are unproven and sceptical they will keep people away from hospital.

They are demanding more assurance, saying the risks for patients are simply too great to take any gambles.Deputy chairman John Burbeck said: “Last winter was dreadful. It was dreadful for staff and it was dreadful for patients.

“To me it seems that we have all our eggs in one basket and nowhere to go if any aspect of this plan fails.”

Chief operating officer Stewart Messer said a particular bone of contention was winter funding being spent purely on out-of-hospital schemes – with no resources to open extra acute beds when needed, as in previous years.

The trust says emergency demand is still running at about 8.5 per cent higher than planned in its contracts with commissioners.

As a result, 46 additional winter beds are still open at the start of September.

And Mr Messer is sceptical of the numbers improving anytime soon.

“Our clinical commissioning groups (CCGs) anticipate quite a significant reduction in A&E admissions and attendances over the winter.

“But if they are successful in doing this they would be bucking the trend of the last few years and bucking the trend that is being seen up and down the country.

“We still have little confidence that this is not going to be sustained over the coming months.” However, Simon Trickett, chief operating officer of South Worcestershire CCG, is confident that the winter plan will deliver.

“Many of the schemes were successfully introduced last year during the winter period so we are confident that they will help to meet the challenges of increased demand, particularly from more elderly patients and those with more severe illnesses.

“So far this year hospital admissions from patients who live in South Worcestershire are already 6.7 per cent lower than last year, so the signs continue to be encouraging. However, we will of course continue to monitor all of our schemes to ensure that they continue to deliver our intended reductions.”