The boss of University Hospitals of North Midlands NHS Trust (UHNM) has laid bare the extent to which targets are being missed as a result of Covid-19 and staffing pressures on the health service.

In a meeting with councillors at Staffordshire Moorlands District Council, the trust's CEO Tracy Bullock said a number of targets were being missed – all of which stemmed back to staff and capacity issues, many of which have resulted from dealing with the Covid-19 pandemic.

The four-hour target for treating patients requiring urgent care is not currently being met – but the trust will soon be using different measures to grade its performance in this area.

Ms Bullock said: "Being in A&E for four hours isn't necessarily wrong.

"If a patient needs to be in in A&E for four hours, six hours, eight hours – because of the treatment they need – then that is the right thing to do for that patient.

"Some patients do need to be in A&E for longer than that. You only need to watch something like '999 Critical Condition' which shows our A&E and our major trauma centre.

"There is no way any of those patients that have life- and limb-threatening conditions are going to be in A&E for simply four hours. That isn't relevant and it isn't appropriate either.

She said the target is due to be scrapped in favour of other measures – but few of those targets are currently being achieved.

Ms Bullock explained: "Some of that is about workforce, and some of that is about Covid-19.

"There are very few trusts in the country that are achieving those targets, because of the pressures we're under at the moment."

She said the health service was experiencing its sixth surge of Covid-19, and the number of patients with Covid-19 at Royal Stoke Hospital had risen from 50 to 250 in the past month.

Ms Bullock said the hospital can cope with around 50 patients with Covid-19, and 10 in critical care, without having to take measures such as cancelling elective surgery.

She added that current patients with Covid-19 are fortunately not as poorly as those in previous surges, and very few are in such a serious condition as to need critical care.

Nevertheless, they are among the sickest 4% of people in the country with Covid-19.

Ms Bullock continued by explaining the hospital was also missing its 18-week target for referring patients who need less urgent treatment.

She said: "That is a target that nobody is talking about at the moment, because when Covid-19 first came in March 2020 we were instructed to stop all elective and planned care. That gave us an immediate backlog.

"After about nine months, we started to do elective and planned care, but the backlog remained because we've had another five surges of Covid-19 since then.

"Every time we have a surge that takes us over 50 [patients] that does impact on cancellation of elected procedures."

She said the government is currently focussing on dealing with patients who've been waiting for longer than two years.

Prior to the pandemic, Royal Stoke Hospital had no patients waiting for longer than a year for treatment – now, there are over 600 patients who've been waiting more than two years.

With some recognised exceptions, the trust says it will have dealt with all two-years waiters by the end of this month.

The next milestone will to be for all patients who'd been waiting for more than 78 weeks.

It's hoped this will be achieved by March 2023 but Ms Bullock cautioned it will be challenging and may become unachievable if there are further surges in Covid-19 cases.

She added that the trust also currently had a very high bed occupancy rate, which has reached unsafe levels recently.

She said occupancy of up to 85% was safe as this allows room for deep cleaning, infection control and patient transfers.

The trust is currently running at between 92-98% bed occupancy – and at times has even exceeded this, rising to as much as 110%.

Ms Bullock said: "Those occupancy levels are not safe from an infection control point of view, but unfortunately they are where we needed to be because of the number of patients coming through the doors.

"We are a hospital that has a lot of beds – we have about 1,500 beds – so when we run out of beds it's quite something."

She said the lack of available beds has caused gridlock in A&E, and this has further repercussions – for instance in holding up ambulances waiting to offload patients.

She said the trust had opened up other areas of the site where ambulances can offload, but they can't open any more because there isn't the staffing to match.

Now the trust is working with the Dougie Mac hospice, for patients needing end-of-life care, to share some of the workload.

Ms Bullock explained: "Our beds becomes jammed sometimes because we aren't discharging fast enough; sometimes because social care doesn't have capacity; sometimes because community services don't have capacity; A&E becomes jammed because sometimes mental health doesn't have capacity.

"The issue that we've got around ambulances isn't just the ambulance service's problem – it's all of our problem.

"All of us are working together very hard to try to resolve this."