At the other end of the scale, people turn up with minor complaints after struggling to secure GP appointments. “Last week someone came in with a coldsore,” one nurse tells us.
Experienced staff can redirect those who do not need urgent care, helping them to book GP appointments or pointing them towards pharmacies and other services. Now one in 10 patients are sent away, although staff admit it can lead to frustration.
Security has been tightened following one violent incident, with glass screens installed and 24‑hour guards now in place.
Leicester Royal Infirmary has introduced new measures each year to boost capacity and manage rising demand. Winter pressures continue to grow, while the quieter summer months have become a thing of the past.
To reduce ambulance queues, prefabricated structures were converted into a permanent unit with 14 beds – all are full during the BBC’s visit. Without them that would have been 14 ambulances queueing for hours to unload their patients.
Unlike many hospitals, Leicester’s emergency unit is not totally overwhelmed by elderly patients. Frail patients are streamed directly to specialist areas, including a frailty unit, or supported in the community to avoid long hospital stays.
Preston Lodge, a former care home bought by the trust, now provides 25 beds, with 14 more opening on December 15. Patients who no longer need acute care – but still require rehabilitation or support – are moved there while awaiting care packages.
“We aim to get people better ready for going home and hopefully keep them stronger and more independent so they aren’t back in hospital so frequently over the winter,” says head of nursing, Emma Roberts.
Looking ahead, Mr Mitchell expects waits and delays to only get worse for patients in the coming weeks.
For the first week in January – traditionally the busiest each year – the hospital plans to free up more emergency beds, but that means delaying other operations and procedures.
He says: “We will not be able to provide timely care to every patient this winter but we will continue to do our utmost to ensure that patients are treated with dignity and respect to ensure they receive safe care and we will do everything possible to manage those waiting times.”