NHS: all-year-round crisis!

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Campaigners from St Helier Hospital in south-west London fighting to stop it from closing
Campaigners from St Helier Hospital in south-west London fighting to stop it from closing

THE NHS is in ‘all-year-round crisis’, Dr Rob Harwood, BMA consultants committee chair, said on Thursday. He was responding to new figures A&E attendances & emergency admission statistics that show July had the highest ever number of attendances.

Dr Rob Harwood, continued: ‘With more than half a million people waiting over four months for hospital treatment and a further three-and-a-half thousand waiting more than a year, these figures show that the NHS is well and truly in a year-round crisis.

‘Waiting lists for elective treatment are as long as they’ve ever been and the number of people waiting more than 18 weeks for routine operations is at its highest in a decade. ‘The pressures, widespread across our hospitals and the wider NHS, can no longer be blamed on the winter; today’s figures show they are anything but seasonal. Behind these statistics are patients suffering distress and potentially failing health as they wait months longer than they should for care.

‘Without more sustained investment in staff and services, the NHS will continue to fail to meet demand, patients will continue to suffer unnecessarily, and the current workforce will be stretched even more thinly, compounding recruitment and retention problems. ‘What greater evidence does the government need to act, to give the NHS more funding to halt its decline and put the health service on a sustainable footing for the future?’

President of the Royal College of Emergency Medicine, Dr Taj Hassan, said: ‘The recent heatwave will have had an impact, but this should not be used to excuse inappropriate resourcing. ‘It should also not come as a surprise that whatever the weather conditions, working in a continually under-resourced and declining system has consequences – all of which are detrimental to our patients.

 

‘The continued increase in demand, due to wider system failures and the hot weather, has led to patients and staff suffering in unbearably hot conditions on wards and in waiting rooms. ‘Long waits are unacceptable at the best of times, but when this is done within systems that are struggling already to cope this adds to the pressures on staff to be able to deliver safe, effective care.

‘When plans are drawn up for the forthcoming, and very welcome, funding settlement, the needs and safety of patients must be at the forefront of thinking. ‘We would strongly urge that money is not wasted on redirection strategies, but that significant investment is given to where patients actually go to be treated in a timely fashion in the Emergency Department as well as more acute beds to create capacity and flow for our ill patients. 

‘However, this extra funding cannot come soon enough. We know it seems unlikely to be available to help staff care for patients and improve performance going into the winter. ‘These latest figures show that we are in danger of slipping backwards and that we haven’t fully recovered from the last winter; we will be entering autumn and next winter with one arm tied behind our back.’

Meanwhile the number of patients facing long waits to see their GP has doubled in six years, new data shows. The official figures from a mass survey of the public show almost one in four patients waiting at least a week to see their GP. The survey of 760,000 patients shows that 21.6 per cent of patients tried to access their GP services but found that their service was closed.

One in three of those patients decided to turn to A&E services as an alternative, increasing the burden on already overcrowded hospitals. In total, 23.8 per cent waited at least a week to see a GP – a rise from 12.8 per cent in 2012.  Just 11 per cent see someone the next day. And 27.9 per cent of those polled said it had been difficult to get through to their GP surgery in the first place – a rise from 18.6 per cent in 2012.

This compares to 70.3 per cent of people who said it was easy to get through, although this figure has fallen from 77.9 per cent in 2012. The figures, from polling between January and March, showed falling satisfaction levels, with 68.7 per cent saying they had a good experience of making an appointment, down from 72.7 per cent in a year. This marks a decline of 10.6 percentage points in just six years.

John Kell, Head of Policy at the Patients Association, said: ‘Patients are very obviously suffering the consequences of the long period of below-trend growth in NHS funding and long-term failures in managing and developing its workforce. ‘It can be unbelievably stressful to face a long wait or period of uncertainty even before getting to see a doctor, quite apart from prolonging the length of time someone has to live with the medical issue that is troubling them.’

Beccy Baird, Senior Fellow at The King’s Fund, said: ‘This year’s GP survey figures reflect the real challenges facing general practice, with over a third of patients struggling to get an appointment when they need one. ‘Just 62 per cent of people said that they could see or speak to someone at a time that suited them.’

Prof John Appleby, chief economist at the Nuffield Trust said: ‘July 2018 was the most pressured summer month for A&E departments in recent history, showing that there’s no doubt this summer’s heatwave has caused severe strain on the NHS. ‘It is usual for A&E attendances to spike during the summer, but this year they were the highest since monthly reporting began in 2010. ‘Figures from today’s GP patient survey serve as a reminder that these pressures are not isolated to A&E.

‘One in three people who wanted to speak to a GP when their practice was closed say they went to A&E instead.’

The GP survey found 83.8 per cent of patients described their overall experience of their GP practice as very or fairly good, a fall from 88.4 per cent in 2012, and from 84.8 cent in 2017. The proportion of patients rating their GP surgery as poor has almost doubled in six years, increasing from 3.6 per cent to 6.1 per cent.

Dr Nikita Kanani, acting director of primary care for NHS England, said: ‘General Practice is the foundation of the NHS and this survey shows patients appreciate the fantastic job GPs and the wider primary care work force are doing in times of real pressure, helping more people living with increasingly complex conditions.’ Her predecessor Dr Arvind Madan resigned on Sunday after admitting posting anonymous comments accusing GPs of being overpaid and that the closure of small GP practices was beneficial to other GPs.