Doctors and nurses warn cuts mean new winter crisis

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Junior doctors on a demonstration fighting against cuts and for better wages for NHS staff – there is another winter crisis looming
Junior doctors on a demonstration fighting against cuts and for better wages for NHS staff – there is another winter crisis looming

DOCTORS and nurses slammed government cuts and warned of a new winter crisis in response to the latest NHS Digital performance figures released on Thursday. The August performance figures show the NHS entering autumn in a fragile state, said the President of the Royal College of Emergency Medicine, Dr Taj Hassan.

The figures recorded that 78.2% of people received a first definitive treatment for cancer following an urgent GP referral for suspected cancer within 62 days.

This is the lowest percentage since records began in October 2009. In August 2018 there were 1,995,405 A&E attendances. In August 2017 there were 1,924,663 A&E attendances.

In August 2018, 89.7% of the number of people attending A&E were seen within four hours. The four-hour target for the number of patients being seen within four hours is 95%. This was last achieved in July 2015.

Dr Taj Hassan said: ‘These figures show that last month was the worst August on record in terms of hospital wide system four-hour performance. ‘They show that despite the best efforts in terms of planning we will be entering autumn and winter in a very fragile state with little room for manoeuvre unless more urgent action is taken with funding for winter. ‘Safety for patients and staff must be an absolute priority.

‘A small minority of emergency care systems that are appropriately funded will manage to achieve adequate flow and performance that will ensure safety and allow staff to deliver timely care linked to acuity which is their job. ‘Overall attendances are up and again bear out the vast increase in patients that staff are treating – something also made clear by today’s report from NHS Digital, showing a 22% increase in attendances over 10 years.

‘We are also edging closer to being in a position where nearly a third of all patients attending a Type 1 Emergency Department (ED) require admission, meaning that getting more staffed beds is vital. ‘Every hospital Trust must also ensure that they link well to their community and social services to minimise the number who are medically fit but are unable to be discharged.

‘For some major EDs to have a 4-hour percentage in the 50-60% range in summer is a major source of risk and these hospitals must ensure that the limited winter pressure funding is committed to ensuring safety. ‘It is also crucial that these hospital Trusts ensure that they are fully engaged trust-wide to take ownership of this target, to improve flow and hence improve conditions for patients and the staff who have to work in such tough conditions in the Emergency Department.’

Responding to NHS Digital figures which show A&E attendances up 22 per cent in 10 years and more patients spending 12 hours in emergency departments than ever before, Dr Rob Harwood, BMA consultants committee chair, said: ‘These statistics paint a bleak picture of what both staff and patients in A&E departments across the country face on a daily basis, and should serve as a warning for the future. ‘They clearly show that the worrying increase in demand that doctors have been warning about for some time is now a reality – yet there is no additional capacity to meet this.

‘The number of patients spending more than 12 hours in A&E is now at an all-time high. ‘This is an unacceptable amount of time for patients with urgent health needs, and for whom any wait can be both physically painful and distressing. ‘As summer draws to a close, winter will present its usual problems for A&Es, with further pressure leading to even longer waits, cancelled operations and a shortage of beds.

‘Extra capacity must therefore be built into the system, by investing in staff, resources and services, if the BMA’s projections of a year-long crisis are not to become the new normal. ‘While doctors in hospitals across the country will endeavour to provide the best possible care in increasingly difficult circumstances, without assertive, joined-up action from government and policy-makers, both staff and patients will continue to bear the brunt.’

Tom Sandford, Director of the Royal College of Nursing for England, responding to the latest NHS England combined performance figures, said: ‘With winter just weeks away, these figures paint an alarming picture of an NHS still reeling from a heatwave summer our healthcare system could barely cope with. ‘Admissions are up on last year, the four-hour target has not been met since July 2015, and the system has still not caught up with the backlog of operations cancelled last winter. ‘Most worryingly of all, last month saw the lowest ever percentage of cancer patients treated within the government’s target of 62 days.

‘This bald statistic represents untold stress and misery for thousands of patients and their families. ‘The 62-day limit isn’t an arbitrary figure but was recommended by clinicians as the best way to try to halt progression of the disease – cancer nurses see at first hand the distress breaching the target causes patients.

‘If heatwave summers are to become the new normal, it is clear the Prime Minister’s promised £20bn for the NHS cannot come soon enough. ‘The government must draw up and fund a comprehensive workforce plan that responds to a growing and ageing population. ‘This is the only way to safeguard the future of patient care and begin to improve the dire state of our struggling healthcare system.’

• Niall Dickson, chief executive of the NHS Confederation, which represents trust bosses and clinical commissioning groups, said: ‘This may look like an NHS that is failing – one target after another not being met. ‘In reality it is anything but – this is a service that is stretching every sinew to meet rising demand, but it simply does not have the means to do so. ‘And behind the cold impersonal figures are real patients with real stories and staff, too many of whom are under incredible strain.

‘Targets such as a limit of four hours to wait in A&E, how long it takes to see a specialist doctor, the number of patients unable to get out of hospital – all these can spell individual patient misery and overstretched staff.’

However, Dickson then opened the door to furthering the Tory government’s privatisation drive and more hospital closures. He said: ‘We have to change the model, to support patients in their communities with hospital becoming the last not first resort. England is about to have a long-term plan – it is a chance to roll out a different approach but it will need radical thinking and more investment in GP, community health and social services.’

In a bid to soften his direction of travel, he concluded: ‘Every day, NHS staff across the country are doing their very best – but there are more than 100,000 vacancies – they cannot work miracles.’

BMA member and former surgeon Anna Athow said: ‘These figures are the direct result of the Tory government’s onslaught on the NHS with thousands of beds cut, wards closed and staff haemorrhaging under the workload pressure and poverty pay.

‘The five-year plan is a closure and privatisation plan.

‘The TUC must be made to call a general strike to bring down the Tories and go forward to a workers government carrying out socialist policies, including the nationalisation of the banks and pharmaceutical giants to fully fund and develop the NHS.’