‘THE GOVERNMENT must resolve the long-term funding, capacity and recruitment issues’ if it is going to avoid a ‘winter crisis’ all year round, doctors union the BMA has warned, responding to the new NHS digital A&E figures.
Shockingly, the figures for September 2016 released by NHS digital show that 53,000 people left Accident and Emergency Units before receiving treatment. Dr Mark Porter, BMA council chair, said: ‘It is clear from these figures that patients are being let down by an overstretched system.
‘The delays that patients are facing, for the care they need, have almost become the norm and this is unacceptable. Demand is now so great that hospitals are experiencing a year round crisis. Front-line staff are under serious pressure and are working flat-out, but the system can’t cope with the number of patients needing to move through acute care, as the entire system is congested.
‘The entire health and social care system needs more capacity, including in accident and emergency departments, general practice and social and community care. The government must resolve the long-term funding, capacity and recruitment issues facing the system as a whole if we are to get to grips with the pressures hospitals face year in, year out, and which, as we are currently seeing, are compounded during the winter months.’
The new figures reveal that record numbers of patients are leaving A&E units without being treated. In all, 53,000 people left an emergency department in England in September before receiving treatment, 24% more than the 42,461 who did so in September 2015.
Data released by NHS Digital on Wednesday did not include patients’ reasons for leaving, but many are likely to have done so because they felt they had waited too long to be seen. The number of patients who have to come back for further treatment within a week of their first visit is also increasing quickly.
Experts warn that trend may indicate A&E staff are struggling to provide the highest standard of care because they are now too busy too much of the time. In September 137,164 patients (8.1% of all 1.68m attendances that month) came back to an A&E in an unplanned way within seven days of their first attendance, 14% more than the 119,856 (7.6%) who did so in the same month a year earlier.
Professor John Appleby, chief economist and director of research at the Nuffield Trust health thinktank, said: ‘There is no doubt that this winter will be exceptionally tough across the NHS. A&E targets have been missed for months, record numbers of patients are waiting on trolleys to be admitted to hospital and, as today’s figures show, there is a worrying rise in people going back to A&E units within seven days, raising questions about whether they’d had the right treatment or advice.
‘These figures paint a picture of an NHS under severe pressure, which will put staff under great strain over the winter period and could put patients at risk. The NHS has managed in previous years by opening extra beds, deploying more staff and reducing the numbers of non-urgent operations. We expect to see the same this year, but the question for this winter is whether there will be enough slack in the system to deal with a sudden outbreak of flu or norovirus.’
NHS Digital’s latest figures also show that the time it takes for a patient to start treatment in A&E has gone from 55 to 59 minutes in the last year – a 7% rise. In addition, while last year 95% of all A&E cases left the unit within 5hrs 53mins of arriving, this September it took 6hrs 30mins for emergency departments to reach that 95%.
NHS Improvement, the health service’s financial regulator, last week ordered hospitals not to carry out non-urgent surgery over Christmas so that beds are left free to help deal with a potential influx of patients. Jim Mackey, the agency’s chief executive, told hospital bosses that the NHS is facing a ‘critical’ time.
Meanwhile, separate new findings show that the NHS is on track to have its most difficult winter ever. A total of 785,883 patients could end up waiting more than the supposed maximum 4hrs for A&E care in the December to February winter months, far more than the 613,971 who did so in those three months in 2015-16.
That projection is based on the 28% year-on-year rise in such delays seen every year between 2010-11 and 2015-16, according to Incisive Health, a specialist health communications and policy firm. Similarly, trends over the last six years suggest that A&Es in England may have to treat as many as 5.76m patients over the winter period, up from 5.65m last winter.
This winter is also likely to see more people than ever before – an estimated 185,715 – forced to wait more than 4hrs before being admitted to hospital as an emergency, they say.
• The NHS have launched a drive to help homeless people after patients were turned away from surgeries. Some 10,000 ‘My Right to Healthcare’ cards will be handed out to homeless people in London, advising them of their rights. Surgery staff have wrongly been turning homeless people away because they have no ID Rex.
The NHS is launching a drive to improve access for homeless people to healthcare, after admitting some staff were wrongly turning them away from seeing GPs. Some surgeries have been wrongly stopping homeless people registering at GP surgeries because they have no proof of address or ID, even though NHS guidelines are that the documents are not required.
The NHS’s London Homeless Health Programme, an NHS initiative to improve healthcare in the capital for homeless people, is to improve training for GP receptionists and practice managers as a result.
A recent report from the NHS’s Healthy London Partnership and homeless charity Groundswell, which included the results of over 90 interviews with people who are homeless in the capital, found that people who are experiencing homelessness often find it difficult to register with GP practices and that practices did not always understand their needs.
People who are homeless and living rough on the streets in London live significantly shorter lives, and single homeless people across the country are five times more likely to use A&E services.
Dr Adrian McLachlan, a Lambeth GP and clinical lead for Healthy London Partnership’s London Homeless Health Programme, said: ‘Being homeless can seriously affect your physical and mental health. People who are homeless have the same right to healthcare as the general population and we hope the cards will make it easier for them to get the care they need.’
More than 150,000 young people facing homelessness seek housing support each year – but up to a third are turned away with no help.