The unrelenting pressures on the region's largest hospital has been laid bare by its chief executive.
In a wide-ranging interview with this newspaper, Sam Higginson, chief executive of the Norfolk and Norwich University Hospital described the demand facing the site in Colney - from a renewed surge of Covid infection to scores of patients blocking beds.
On the Covid situation
The past two weeks have seen the number of patients in the hospital with Covid soar to the highest they have been since January 2021.
As of July 5, the most recent NHS figures available, the hospital was treating 137 patients with the virus. Mr Higginson said this figure had since surpassed 150.
However, he said the majority of these were in hospital with Covid, rather than because of it - and just three were in intensive care.
But the virus was nonetheless still posing challenges and recent saw the requirement for visitors to wear masks reinstated.
He said: "We are definitely seeing a further wave of Covid at the moment and this is a level of infection we have not seen since Janaury 2021.
"At the moment we have not changed visiting arrangements but we are keeping that under constant review.
"We do really like to make sure families can access their relatives - they love it and our staff love it - but if things continue to deteriorate at the same rate we may have to review that."
He added that Covid continued to be the main cause of staff sickness and absence.
On demand for beds
Mr Higginson said the hospital was under such demand that it had been forced to once again cram extra beds onto wards.
The controversial measure used before Christmas saw seven beds squeezed onto wards designed for six, meaning patients have less space and fewer privacy measures - but allowed more to be treated at once.
He said that a combination of high demand and delays in discharging meant the measure has had to return.
He said: "We are full. We currently have 180 patients in hospital with no criteria to reside."
This is a term used by the NHS to describe patients who are physically well enough to not require hospital treatment but not well enough to be at home without some form of care.
These patients, therefore, can not be discharged until they either have a place in a community hospital or care home, or a care package allowing them to be looked after in their own home.
This means that one in every 10 beds in the hospital, which has a capacity of 1,200 beds, is occupied by somebody not requiring treatment.
Mr Higginson added: "This puts continued pressure on ambulance handovers and meant we have had to made the difficult decision of putting seven beds in six-bed sections.
"We know this is not ideal but it is safer than having ambulances that can not be unloaded."
On the region's big healthcare shake-up
Mr Higginson described the recent shake-up of the region's healthcare system as "a fantastic opportunity", citing the discharging troubles as a main reason it was necessary.
The sector has recently been re-organised into an 'integrated care system' which will see the health sector and adult social care work together on a much closer basis.
He said: "It is a fantastic opportunity - we are moving from the old NHS where we were encouraged to think as a hospital to one were we are encouraged to think as a system.
"The biggest opportunity is to work with partners to make sure how we can make sure patients are always treated in the appropriate place.
"Historically, the NHS has worked in silos and we need that to stop - in an ideal world people won't even notice when they move from one part of the care system to the next."
On staffing troubles
The most recent NHS staff survey made troubling reading for the hospital, with a quarter of its staff saying they would be looking for new jobs.
Mr Higginson said: "One of the biggest issues is that our staff do not feel they have got enough colleagues in their teams and we continue to see that."
The hospital currently has a staff vacancy rate of 11pc, meaning more than one in every 10 roles needed for it to function at full capacity is not filled.
He said efforts to recruit were being redoubled, both domestically and internationally.
He said: "We know we need to do a massive number of things to improve our staff experience, Happy staff mean happy patients so we are clear we need to do better.
"We are doing lots of work to retaining staff too - we are running wellbeing days where we try to give staff a chance to recharge and we are investing in more facilities for them.
"We are also investing in training to develop our staff more."
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