The medical director at the James Paget Hospital is urging patients to fulfil appointments as it is "coping well" with the ongoing spike in Covid-19 cases.

Dr Hazel Stuart, medical director at James Paget University Hospital (JPUH), encouraged people to continue to attend their appointments at the hospital, which as of Thursday had 35 patients being treated for Covid-19.

Staff sickness levels are at 6pc - which is in line with usual winter sickness levels - however, staff absences have risen to 11pc, but mostly due to the need to isolate.

Her assurances came despite the NHS in Norfolk moving to its highest alert level on Tuesday, while the East of England Ambulance Service Trust (EEAST) has been on its top alert level since the summer.

Dr Stuart said: "We are open for business.

"Our current sickness rates are similar to our usual winter sickness rates.

"But most of the pressure from our staff absences are due to isolation as opposed to them actually being sick.

"It is important that people in a household with someone who is Covid positive shouldn't come to work.

"However, we are functioning as normal from all our urgent and emergency departments and our cancer work.

"And we really don't want anyone to miss any appointments."

Dr Stuart said the hospital was busy but "coping well" despite operating at capacity most days.

"The hospital is very busy - we're usually busy at this time of year with winter pressures - but we're exceedingly busy at the moment," Dr Stuart said.

"We have a lot of sick patients requiring admissions, our emergency department is equally busy with patients requiring help there and we are seeing an increase in the number of Covid patients as well.

"We've got 35 inpatients with Covid this morning.

"We also have between 30 and 40 patients on what we call a virtual ward - with patients who don't require oxygen but are still poorly and we send them home quite often with a monitor and we follow them up with a clinical review every day."

However, not all patients on the virtual ward are Covid-related.

The director confirmed that the hospital did not have any confirmed Covid patients on intensive care as of Thursday morning.

Dr Stuart said: "I think that's one of the things we're seeing as a slight difference with the Omicron compared to the Delta strain.

"On the other hand, intensive care admissions are usually significantly delayed compared to the community peaks.

"And we probably haven't reached our community peak yet in Norfolk.

"So the delay to hospital admissions and intensive care may still come, but at the minute we're not seeing that pressure."

The director accepted that if Omicron cases were to increase, staff sickness would likely follow.

JPUH currently has approximately 80 patients who are "right to discharge" and have done for the past several months.

"We have about 80 patients who are right to discharge - they have finished their care but some of them still need some kind of input," Dr Stuart said.

"But they are a mixture of patients requiring different levels of care and different things to be done to get them home or to their care homes.

"We have seen some improvement in the number of patients with a delayed discharge over the last couple of months.

"Norfolk and Waveney Clinical Commissioning Group are co-ordinating a lot of this work to get some leverage to move it forwards.

"We are equally aware there are pressures on both the community and social care for staffing.

"It is a system approach and we have to work to ease the pressure across the system.

"We're maintaining staffing levels across the trust to the best of our availability and we're in the process of setting up a ward full of nurses who will be allocated to the virtual ward.

"They will be available every day to be brought into an area that may have significant shortages.

"Effectively, we have over-employed the number of nurses we need.

"We have spare capacity to help with this process."

Dr Stuart stressed that patients with appointments should continue to attend them.

"If you can't attend, please let us know so we can utilise that slot for someone else," Dr Stuart said.

Winter problems

The Paget has endured a difficult winter as Covid and usual winter pressures hit.

In October, a patient died because so many ambulances were stuck outside the hospital, meaning that nobody could respond to their 999 call.

Not one ambulance from Cromer to Waveney - a distance of almost 50 miles - was free, meaning the woman had to wait an hour for a crew to come from Ipswich - but she had died by the time it had arrived.

The 999 call - from the Waveney area - was classed as the most urgent, meaning a crew was meant to be on the scene in eight minutes.

However, nine ambulances were stuck at the James Paget University Hospital in Gorleston waiting to unload other patients.

Another patient died in October after suffering a heart attack while waiting in an ambulance for more than two hours outside the hospital.

What you can do to help with busy hospitals

As well as sticking with current appointments and seeing healthcare professionals when you have a serious illness or query, Dr Stuart encouraged people to help the elderly and vulnerable in their communities as it can make all the difference.

People are also reminded to get their vaccines and boosters, as well as take regular Lateral Flow Tests to prevent the spread of COVID, as it can all help prevent admissions.

A&E is for serious emergencies only and people should dial 111 first, so they can be directed to the most appropriate place.