Norfolk hospital 'bed blockers' cause A&E failures
A Norfolk hospital is failing to get patients arriving by ambulance into A&E within target times because of bed blocking, its chief claims.
As a result, the Norfolk and Norwich University Hospital faces a £70 penalty every time it happens, although these financial sanctions have not yet been applied.
The Norwich hospital has the worst record in the East for time taken to transfer patients, BBC Inside Out has found.
The East of England Ambulance Service (EEAS) has one of the worst records in England for time lost waiting at hospitals.
The Broomfield Hospital in Chelmsford, Essex, was also experiencing similar problems earlier this year.
Both the hospitals and the ambulance service are working to address the issues and are aware they must improve their performance and prepare for changes to their operations in January.
Norfolk and Norwich University Hospital chief executive Anna Dugdale said delays were being caused by patients not being taken "out of the back door".
New arrivals cannot get into the accident and emergency area because patients are already occupying bed spaces.
Size not limiting factor
These patients are often waiting for others on the wards to be released after treatment or discharged by busy doctors or nurses.
Others are awaiting beds in after care units and this is often organised by social services.
In February the hospital had the worst performance in the East of England for delays in receiving patients from ambulances and delivering them to the accident and emergency department.
In September NHS Norfolk found the hospital still had the worst performance for delays with patients waiting at least an hour before being admitted.
The hospital is now required to admit 85% of patients arriving by ambulance within 15 minutes.
In October the hospital failed to meet that target.
Ms Dugdale said at the time that 46 beds in the general wards were occupied by patients who were medically fit to leave but were waiting for a care package - such as support from social services.
"The size of the A&E department isn't the rate-limiting factor.
"The issue is when we can't move patients through the department quickly because we can't get patients out of the back door of the hospital.
"We are doing a great deal of work with the local clinical commissioning groups across Norfolk and also with Social Services to improve the handover performance.
"I think it's not just this hospital, it's the whole health and social care system.
"So this target is a manifestation of what's going on in the system as a whole.
"If we can flow patients out of the hospital then it's much easier to admit patients which is why we're working with the care commissioning group to improve the whole system's performance."
Inside Out East is on Monday at 19:30 GMT on BBC One