UNRELENTING pressures on "exhausted and frustrated" nurses are forcing the closure of beds at the Royal Bolton Hospital.

The strain of Bolton's bed shortage is taking its toll on the town's accident and emergency unit -- with an 84 per cent rise in the number of patients waiting more than four hours on trolleys in hospital corridors.

Figures revealed to the Royal Bolton Hospital NHS Trust yesterday also show that five beds on D2 ward still remain closed since June 18 due to high levels of sickness and staff vacancies.

And seven beds on F5 closed for a period of six weeks last month.

There are 120 unfilled vacancies among Bolton's nursing staffing, forcing the trust to use a pool of staff from their reserve nursing banks.

Deficit

This has resulted in a £356,000 deficit for the trust in the past month -- with predictions that if the pressure on beds continues, the hospital faces being £3 million in the red.

The catalogue of bed shortages has been revealed by Beverley Andrew, hospital director of operations, at the same time that the trust's finance director, Beverly Peacock, revealed the cashflow problems.

As reported in the BEN two weeks ago, operations at the Royal Bolton Hospital are being cancelled because the hospital is under strain from a rise in emergency admissions.

The strain on beds is also being blamed on an increasing catchment area, as patients from Leigh are brought to Bolton's casualty department instead of being taken to Wigan's accident and emergency department.

Scores of patients are being told that their operations have been cancelled because of an unexplained rise in life-threatening admissions.

There is also a rise in the number of elderly patients taking up acute beds, forcing the hospital to "buy beds" in Bolton Council social services' nursing homes.

In a report to the Bolton Hospitals NHS Trust Board yesterday, Mrs Andrew said: "Staff within the trust have worked extremely hard and many are now clearly exhausted and frustrated due to the relenting pressures they are working under."

She added: "The ability of the trust to cope with such large numbers of patients is causing concern and requires urgent attention."

Admissions to A&E have increased by 10.3 per cent compared to last year. This has caused an increase in patients waiting on trolleys for a bed on a ward -- up by 84 per cent compared to the period from January to May 2000.

The trust, which first paid to use spare beds in nursing homes at Christmas to relieve pressure on wards for the elderly, has since doubled the number of those beds being used, with more urgent meetings planned with social services this month. At the end of May 5,064 patients were waiting for admission, with 76 patients waiting longer than 12 months due to the increasing number of operations being cancelled.

At yesterday's meeting, held at the Royal Bolton Hospital, the head of nursing, Sue Reed, called for a need to balance finances without hittng on patient care.

Sue Reed said: "We have to make sure that there isn't a compromise on patient care."

Chairman Peter Liptrott agreed and said: "Absolutely, but if we haven't got beds, then we've got a problem."

Finance director Beverly Peacock told the board she had strongly worded the warning to "give the message internally and to purchasers".

Pressures

She added: "We are trying to meet the great pressures in coping with the volume of levels of sickness that presents itself at the hospital doors."

An increase in sudden admissions from neighbouring Leigh and Wigan, following the closure of the Leigh A&E department in 1997, is adding to the strain on beds in Bolton. Hospital bosses are to meet with Leigh and Wigan Primary Care Groups to discuss ways to reduce this demand on the Bolton service.

Jenny Crabb of the Community Health Council, an independent body representing the town's 265,000 potential patients, said: "We are very concerned about the impact on patient services."