The health service has hit its annual winter crisis.
16,900 people had to wait in ambulances for hospital care in Christmas week. 4,700 of those had to wait in an ambulance for more than hour to be seen. Media images of five, ten, fifteen ambulances queueing outside A&E departments have become common.
An 81 year old woman in Essex was found dead in her home when an ambulance arrived four hours after her initial 999 call. In Portsmouth an 88 year old woman died after five hours in an ambulance and two hours on a trolley waiting for a hospital bed.
On 15 December the Independent reported that one-in-five NHS trusts had run out of beds on at least one day so far this winter — a situation that will only got worse as winter progresses. On New Years Eve 12 hospital trusts reported 100% bed occupancy. Yet on 8 January Health Minister Phillip Dunne told the House of Commons that there are "seats available" in hospitals which run out of beds.
On 3 January 21 trusts (many with multiple hospitals) were on ″black alert″, meaning they can no longer guarantee patient safety or provide their full range of services.
Around 50,000 operations have been postponed in order to free up beds and ease the crisis.
For years there has been increasing concern about the capacity of the health service. Two years ago junior doctors went on strike to highlight the bad implications for patient safety in the terms of their new employment contract. In the winter of 2016 the Red Cross said there was a ″humanitarian crisis″ in the NHS. In some A&E departments it has felt like last winter never ended.
While the Secretary of State for Health, Jeremy Hunt, exchanged factoids with celebrities on Twitter about the state of mental health, and argued he should not only to keep his job but add social care to his brief, those who provide healthcare have gone beyond breaking point.
I’ve worked in departments with longer wait times, worse morale and sicker patients. I’ve never seen situation where the three have combined so toxically and caused so much avoidable risk of patient harm. What’s worse is that this is crisis has hit all hospitals across the country.
NHS workers are incredible, working above and beyond their job description, again and again trying to meet the needs of their patients. But the hard work of individuals are not going to fix this problem. From fellow junior doctors across the country, I hear the same reports — not enough staff, not enough beds, too many patients. Reports of critically ill patients being told by 111 to stay away from hospital; others without clinical need being told to come straight to hospital.
It's time for some honesty about the state of our NHS from those at the top.
We knew last winter was catastrophic, we know that this winter′s flu strain is worse than previous years. Yet the planning and preparation for this winter has been woefully inadequate.
The government's “solution”, Sustainability and Transformation Plans (STPs), now being implemented in England are not going to improve matters. In my region either Darlington or North Tees A&E is threatened with closure as part of these plans. The risks of these plans become apparent when I was caring for a patient in North Tees who has been transferred by ambulance from Sunderland 30 miles away, because Sunderland, Durham and Darlington Hospitals were all full. STPs are nothing more than cover for cuts to NHS budgets, and can’t provide the sustainability, transformation or plans that are required to drag our NHS back to health.
Bodies like the Accountable Care Organisations are not the way to have an honest conversation about the NHS. They are neither accountable to the population or caring about the state of the NHS.
There is still a huge amount of good will towards the NHS from both patients and staff, but that goodwill is being eroded by the consistent pressure the service is under.
The government should make emergency funding available to recruit extra staff and open more hospital beds.
Employ more clinical staff in the 111 telephone triage service, to better screen for the acutely unwell and at the same time prevent unnecessary presentations at A&E and Urgent Care.
Treat staff with respect and not with empty platitudes.
The NHS funding crisis in numbers
• Between 2010-11 and 2016-17 health spending increased by an average 1.2% above inflation, well below the average of 4% guaranteed to allow growth, spent by governments in the years before 2010, to cover greater numbers of elderly and expensive new treatments.
• In 2015-2016 acute trusts recorded a deficit of £2.6 billion.
• In the budget the NHS received a £335 million bailout and an extra £1.6 billion for the next financial year. This is about half of what it needs to keep up with demand.
• Britain is 24th out of 34 OECD countries in terms of numbers of doctors relative to population.