‘NHS emergency care is itself, in a state of emergency’

Marchers on a demonstration demanding an end to the privatisation of NHS
Marchers on a demonstration demanding an end to the privatisation of NHS

‘EMERGENCY care is itself in a state of emergency,’ Dr Taj Hassan, President of the Royal College of Emergency Medicine said on Thursday.

He was responding to new A&E figures published by NHS England showing the true extent of the winter crisis which the NHS is currently in the middle of.

‘These figures bear out the repeated warnings of the College and others,’ continued Dr Hassan, adding: ‘Patients are suffering due to inadequate planning and resourcing. ‘December saw the worst ever four-hour performance at our major departments at just 77.3%.

‘In the first week of January bed occupancy stood at 95% – a danger to patient safety, with around 7,000 fewer beds open than in the same period last year. ‘Our emergency departments are not just under pressure, but in a state of emergency. This is not just business as usual and these figures make clear the scale of the situation.

‘In the last week we’ve seen images of patients laying on floors while they wait to be seen or treated – patients deserve better than this. ‘The frustrations of our overstretched staff are plain to see; with a large group of emergency department clinical leads pushed to the point of writing to the Prime Minister to ask for action. The sentiments and solutions within the letter are echoed by the College.

‘Things have deteriorated further from last year and the plan has not worked. Urgent action is now required from NHS England and the National Emergency Pressures Panel – a panel the College is not part of – and we have made recommendations to them that should provide stability and safety in the short term.

‘However, in the medium term, we are going to need investment in staffing, beds and social care to rescue a system that’s on its knees.’

Chaand Nagpaul, BMA council chair, said: ‘Hospitals exist to treat the ill, to make people better, and yet doctors are reporting that patients are dying in hospital corridors and hospital leaders are warning of a watershed moment for the NHS.

‘Doctors will be horrified but not surprised by these figures,’ Nagpaul continued, ‘Behind each statistic is a patient waiting longer for care, often in distress, and doctors working under impossible conditions, exhausted and frustrated that they can’t provide the compassionate and quality care they want to for their patients. ‘These echo concerns we’ve had from our members across the country and the government must now take action.

‘Despite the current pressures, I believe our health service is one of the best in the world, but with funding lagging behind that of other comparable European countries we urgently need politicians of all parties to come together and agree a long-term funding plan for the NHS.

‘Failing to do so will leave the NHS lurching from one crisis to the next and will undermine the delivery of safe, high quality and timely patient care.’

Donna Kinnair, director of Nursing, Policy and Practice at the RCN, said: ‘The figures demonstrate why NHS Providers are calling this a watershed moment for the Health Service.

‘Fewer Trusts than ever before were able to meet the A&E four-hour target, almost 100% of hospital beds were full every day last week, way above the 85% safe limit recommended by experts, and almost 1,000 beds a day were lost to Norovirus outbreaks.

‘We can no longer call this a winter crisis – without more staff and more funding for the NHS, this crisis risks continuing to run well into spring and summer.’

• Cancer Research UK says unless urgent action is taken cancer sufferers could die earlier because they have too few nurses to administer chemotherapy.

Their warning came after a leaked memo revealed that a leading NHS cancer centre may have to make patients wait longer to start chemotherapy or cut the amount of drugs they receive because it has huge staffing problems.

Macmillan Cancer Support said the prospect of the Churchill hospital in Oxford in effect rationing life-extending and potentially life-saving chemotherapy was alarming and could deny the dying ‘precious time’ with their loved ones. ‘A group who may be particularly affected by such a decision would be those who have treatable but not curable cancer,’ said Dr Karen Roberts, Macmillan’s chief nursing officer.

‘Chemotherapy can help relieve their symptoms, extend survival and enable people to spend precious time with their family. If access to treatment is reduced, all these factors may be affected.’

The possible limiting of vital cancer care in this way is thought to be unprecedented.

It is set out in an email from Dr Andrew Weaver, a consultant oncologist and the Oxford hospital’s chemotherapy lead, to fellow cancer specialists there.

Weaver, who sent the memo on 3 January, identified a 40% shortfall in the number of specialist cancer nurses as the key cause of ‘difficulties’ the hospital’s day treatment unit (DTU) is having in giving rising numbers of cancer patients chemotherapy quickly enough.

Limiting access to it could affect both newly referred cancer patients and those in their final weeks or months of life.

Weaver writes: ‘Currently we are down approximately 40% on the establishment of nurses on DTU and as a consequence we are having to delay chemotherapy patients’ starting times to four weeks.’

Two types of cancer patients will continue to receive their chemotherapy as planned: dying patients undergoing their first course of chemotherapy and those who are receiving it in addition to other cancer treatment, such as surgery or radiotherapy.

However in future, dying patients could receive less chemotherapy as a direct result of the lack of nurses.

Harpal Singh Kumar, the chief executive of Cancer Research UK, warned that more hospitals may do the same as the Churchill unless ministers urgently tackled big holes in the NHS’s cancer workforce.

‘It’s totally unacceptable that these shortages could lead to delays in patients getting cancer treatment. Immediate action needs to be taken by the government to deal with this, otherwise problems like the one at Oxford will become more widespread and more severe.’