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It’s the story of how that system is starting to creak and increasingly crack under the strain.And hopefully, it might also be the story of how we can fix it.Already, there are six such names: the longest has been here for 7 hrs 41 min.The team go through the wards, hunting for empty beds: “623, full. 625, full.” Every few minutes, the emergency beeper will go off, summoning someone to the phone – usually to be told that a particular bed isn’t free after all.” “They’re desperate to bring the liver over from Worcester.” “Time to be seen is at 1hr 54.” This is the “Ops Centre” of one of the country’s biggest hospitals, where I am spending the week as a fly on the wall.At this and other daily bed meetings, the senior nurses and managers get together to work out who is in the hospital, and where they need to go next.

But the past week has seen packed A&Es across Birmingham and the West Midlands.

He was still on the floor until 3.20pm: the paramedics they sent kept being diverted to more urgent cases. There are no bleeding head wounds tonight, few drunks or drug users.

The QEH is a couple of miles out of town, so the city-centre revellers tend to end up elsewhere – another reason its A&E can usually just about cope.

Then they go through the staffing levels, trying to jiggle things round to free up some extra capacity. I follow Anne Adams, the night shift manager (and, like all the others, a highly experienced nurse), as she makes the rounds.

She spends almost two hours circling the Emergency Department, getting a picture of each team’s needs, constantly borrowing phones to call other wards, juggling patients and manipulating capacity so as to conjure up beds.

Nicky Bartlett, the senior manager on site, opens the meeting by announcing that as of 6.54pm, for the first time in its history, the QEH has gone to Level 4. There are more than 40 in ED at the moment: their complaints include “palpitations”, “painful shoulder”, “headache”, retention (of urine)”, “deliberate self harm”, “cellulitis, toe, left” and “generally unwell”.

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