Learning from failure

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Margaret Wheeler on why government must act to prevent another NHS crisis like the current one

‘Our emergency departments are in a state of emergency’ – a warning from the President of the Royal College of Emergency Medicine and a warning that the government is simply ignoring.

With over 300,000 patients waiting more than four hours in A&E and 75,000 waiting over half an hour in the back of ambulances, front-line doctors were recently compelled to write to the Prime Minister because ‘the current level of safety compromise is at times intolerable.’ Their reality: that the government’s winter plans have ‘failed to deliver anywhere near what’s needed’. Their key demand: more hospital beds and an urgent boost to social care.

The failure is not just of policy and funding; it is operational. We know that Ministers will repeat the mantra of an extra £337million for the NHS this winter – but Trusts weren’t made aware of their allocations until far too late. How could they then undertake the on-the-ground advanced planning to avoid having hundreds of patients a day treated in corridors and sleeping in clinics turned into stop gap wards?

Those involved in the provision and delivery of health and social care services are clear that this extra funding did not even begin to bridge the gap created by huge cuts to the NHS and local government funding of social care in the past eight years. Ministers need to own up to the scale of the crisis they have helped create – and their failure to address the predicted funding gap of £2.5bn by 2020.

The current crisis has consequences not only for those in urgent need but everyone using the NHS. This winter saw the cancellation of 55,000 non-elective operations. For carers, this meant desperately trying to reinstate (also cancelled) domiciliary care support for the hospital stay – and then there’s the dealing with upset, disappointment, continued discomfort and anxiety. Planning for winter has to be across health and social care.

Delayed transfers of care attributable to social care have doubled over the past three years. This means thousands of older people stuck in hospitals around the country unable to go home due to the lack of social care support in place. Carers have been asked by one Trust to ‘come and collect your elderly’ from hospital to help with the discharge process and ease the crisis. The number of carers is increasing every day, with estimates now at around 6.8million. Families are caring more and they need more not less support.           

The government have tried very hard to make Jeremy Hunt’s new title ‘Secretary of State for Health and Social Care’ sound like a fresh and important sign of action and purpose. So let us see the promised Green Paper – and let us see it deal not only with the cap in care costs but also how we can achieve the necessary and fundamental integration of health and social care.

A winter crisis for the NHS has fallout for everyone. Labour has been making this case over and again. But with frontline staff now openly warning of safety issues and the Red Cross delivering tea and blankets to patients waiting in hospital corridors, the government must act to ensure there is no repeat of the current situation.

Baroness Margaret Wheeler is a member of Labour’s health team in the House of Lords

Published 27th January 2018

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