“I have no oxygen,” cries emergency department nurse Lisa Blackwell.
She calls for more supplies such as three ambulances arriving at Chesterfield Hospital in Derbyshire.
The new state-of-the-art A&E unit opened less than two years ago but is already at breaking point.
During several days of filming, BBC News saw 22 cubicles in large bays filled, with beds spilling out into the corridors.
“There’s no dignity in it,” says senior matron Stacey Rison.
An old lady falls on slippery ice outside and has a large gash on her forehead. Blood is dripping from his cheeks. Her son gently tries to pry her away from the tissue as a nurse comes in with a blood pressure stand.
His trolley is lined with five bunks outside the cubicles, while the patient in the front bed vomits into a sick bowl.
Nationally, flu numbers are finally falling. It is hoped that the number of patients will also decrease – but the cold is causing problems.
“Cold and snow are not a good combination for the elderly,” says Dr. Dan Crook, clinical co-lead in the emergency department.
A woman, Ann, had her leg crushed by her car when it slid on ice and pinned her against a garage door.
“A couple of local school kids heard me screaming and eventually enough of them got together to push my car to my rescue. They were amazing,” says Ann.
Patients are also presenting with hypothermia.
Michael Alton, 83, is in the resuscitation bay. When he arrived, his temperature had dropped to 30.6C (87F).
He was found by his neighbor, who decided it would be too long to wait for an ambulance and took him inside.
As soon as the blood is drawn, the heating blanket is quickly activated to try to bring the temperature back to the normal range of about 37C (99F). He is confused and weak.
The beeping of Dan Crook’s emergency pager signals another job and he runs to the ambulance bay.
James Oakes is old, hypothermic and confused. Paramedics fear sepsis.
“He’s a farmer,” Dean says. “He’s been a soldier for a while but now he’s seriously ill. We need to get his temperature and oxygen levels up quickly.”
A patient like James should also be seen in the resuscitation bay but it is full.
Instead he is evaluated and stabilized in the ambulance area. It is only when he is finally transferred to the cubicle that the nurse has time to remove his muddy wellington boots.
“How long will I be here?” he asks. His animals need food. “I’ve never been to a hospital before and I don’t want to stay here long.”
Managing flow through a hospital – that is, freeing up beds by transferring people who are ready to leave – is an important and challenging task.
Dr Hal Miller, a medical consultant and chief executive of Chesterfield Royal, says 80 of the 540 beds are occupied by patients who Are able to leave but cannot due to housing or social care problems.
Some of these patients are admitted even though nothing is fundamentally wrong – they have nowhere else safe to go.
“It makes it very difficult because it means we don’t have the capacity to take care of the people who need the most care but when it’s 02:00 we take care of those people. — it’s the right thing to do,” says Dr. Miller.
The message from Chesterfield staff is that they are competitive, fair, and that they are offering safe care.
But they are clear that it is nowhere near where it should be and, through no fault of their own, the quality is below what they were trained to deliver.