19 December 2008

It's busy

Across the UK the demand for emergency hospital care has been exceptional. Elective work has been cancelled. One London hospital is said to have had to resort to piling up the patients in the endoscopy suite. Ambulances have been queuing outside hospitals waiting for beds to become available. That's no way to treat people needing emergency care. But we are in difficulty. The Secretary of State has had to announce that we do not have a crisis which is what Secretaries of Sate say when we do have a crisis. Yet there is no 'flu epidemic. There is no epidemic of anything. Some 'flu and a bit of norovirus in some places but nothing remarkable. If we have a crisis now what is going to happen when we do have an epidemic?

Why has this happened? It is because NHS beds have been cut and cut. Between 1984 and 2004, the number of hospital beds in England fell by 31 percent, from 211,617 to 145,218. That is a loss of 66,399 beds which is about equivalent to a city the size of Guildford. It's no wonder we are in trouble. Whatever the Secretary of State says.

Money that could have gone to front-line acute medicine and an adequate supply of beds to enable proper bed management has gone to the government's pet projects. Unfortunately the government is keen on supporting black holes.


Anonymous said...

Dr G, you might be interested in this which was posted last night on dnuk:

I am so angry.....

12 year old boy with a fracture of his distal radius. He needs a bed for one night only in order that he can be looked after appropriately before and after his surgery which will be done first thing tomorrow morning.

Simple request.....

I have spent the last 4 hours ringing every hospital in South East London to find a bed. No beds. (Apparently its not the hospital bed managers responsibility to find the bed). The reason we can't keep him here in our hospital is because there are no nursing staff available (fair enough) to look after him (off sick or not willing to pay for the staff - who knows). So what do we do now? Transfer him to Yorkshire/ Bristol/ Northern Ireland (they probably don't have any beds either)? Keep him in A&E here - (they won't do that probably because the hospital gets fined if we do even though there is a bed here and staff able to look after him until he has his surgery).

Mum is at the end of her tether.

This is ranks as amongst the worst kind of "care" I have witnessed in my years as a doctor. I suspect I am not alone in this one....

Dr Grumble said...

According to the The Citizen and the Gloucestershire Echo:

Health bosses say military assistance may be required as the NHS in Gloucestershire reaches breaking point.

The service is under huge pressure following a massive rise in hospital admissions and emergency calls.

Great Western Ambulance Service took 1,000 calls a day at the weekend - a 36% increase on last year.

Coun Andrew Gravells (C, Abbey), chairman of Gloucestershire’s Health Overview and Scrutiny Committee, added: “This unprecedented demand is clearly having a major impact on the county’s emergency services and this is a concern for us all.

“Staff at the PCT, ambulance service and hospitals are working flat out to resolve the situation but if this is not enough then we should consider asking for help from other NHS organisations in the region and even the military.”

Lex said...

Certainly one of the busiest weeks I've worked nights in A+E for years. What is more surprising is that almost everyone I have seen has needed to come... timewaster count has been minimal

Dr Grumble said...

In the last few days Ilora Finlay has asked a question in the Lords about how the government plans to meet their commitment to expanding the numbers of emergency medical consultants.

The reply to such questions is always essentially that it is not much to do with the government because it is for local NHS planners to make appropriate provision. This is part of the continuous effort the government makes to shift the responsibility to somebody else.

Perhaps this Grumble interpretation is unfair. Judge for yourself. The response to Ilora's question is here.

the a&e charge nurse said...

We have been busy the last few weeks......... but nowadays A&E is ALWAYS busy.

The traditional summer/winter peaks/troughs have become increasingly hard to discern, while the "Saturday night in A&E" syndrome has given way to virtually every night attracting more and more patients (from febrile/coughing children, to a growing population of patients with alcohol related problems).

As you have mentioned Dr Grumble the shrinking bed base only intensifies these problems.

A perennial bind for A&E staff is that they are criticised if waits exceed a few hours yet (paradoxically) the same patients criticise A&E staff again, for appearing to be in a rush when it's their turn to be seen............honestly, you just can't win.

First On Call said...

It was very fashionable to speak of the "A&E" crisis in Ireland about three years ago. The government feigned shock when the media reported on elderly patients waiting for three to four days on trolleys before admission to hospital beds. The government tried to blame hospital doctors (incompetent at discharging), GPs (incompetent at managing patients in the community), nurses (more interested in improving their working conditions than caring for the sick) and ignored the overwhelming evidence that this "crisis" had been building since the 20%+ cut in acute hospital beds in the 1980s.

A lot of noise was made three years ago, trolleys became "MAUs", not one extra acute bed was created and instead we were urged to turn to the private sector as the richest country in Europe could easily afford it.

Now as the world economy teeters on the brink, little arrogant Ireland is one of the first to experience an economic collapse. Patients are still waiting on trolleys and the powerful property developers are not so powerful and not so interested in developing landscpaed private hospitals anymore. The government's answer? A proposed 7% cut in the Health budget and the closure of more A&E departments.

With people like this in charge, is it really that hard to understand why our economy and our health service are in the state they are in?

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