Wait watching

PhilHunt2015.jpgPhil Hunt on concerns that overcrowding in hospitals could be resulting in more avoidable deaths

Jeremy Hunt claims patient safety is a core part of his approach to running the NHS. Yet as initiative follows initiative, performance across the health service has declined under his stewardship. So much so, that there are now serious concerns that current pressures on overcrowded hospitals could result in avoidable deaths. The performance figures released for January 2016 are dire, and almost all key targets have been missed.

A&E is a place where few people want to visit but when they do, they expect to receive urgent care. Sadly, only 88.7% of patients were seen within four hours, against the target of 95%. This meant 216,287 patients waited longer than four hours while a further 51,545 spent longer than that on a trolley waiting for an available bed or an operating theatre. A major increase on the 13,161 who found themselves in a similar position in January 2011.

This situation is compounded by the severe problems faced in many ambulance services getting to 999 calls in time. 69.9% of the most seriously ill call outs received a response within eight minutes against a target of 75%. It’s easy to think of these as just statistics, but every delayed ambulance, every target missed is another life put at risk. The human impact is immeasurable, experienced by too many but only reported occasionally, such as the desperately sad case of Roland Volante – a 74 year old pensioner who penned a note to his two daughters saying “I love you” as he died waiting for an ambulance for almost two hours.  

Waiting time problems stretch beyond emergency care. In relation to cancer treatment. 2,034 patients waited longer than the recommended maximum of two months for this to begin. And we have the problem of so-called ‘bed blocking’ rearing its head again, as hospital discharge rates worsen. 103,491 days were lost in this way in January compared with 60,125 in the same month in 2011. That’s many more patients being left in hospital beds while social services try to find suitable care elsewhere while at the same time contending with big reductions to local government funding.

Poor performance of this nature is symptomatic of the huge pressure building up on NHS acute hospitals and it is noticeable that highly respected medical leaders are becoming increasingly concerned. Dr Clifford Mann, President of the Royal College of Emergency Medicine has said it comes “as no surprise to those working in A&E”, and warned of the risk of burnout for the medical and nursing teams working hard to deliver the service. Meanwhile, Dr Mark Holland, President of the Society for Acute Medicine acknowledges that the ability of the NHS “to deliver acute medical care is reaching crisis point”.

Waiting time targets exist to provide swift access to care and have now been missed so often that failure has become the norm. The uncomfortable truth for Ministers is that this is a crisis of their own making, with our NHS under pressure as a direct result of decisions they have made. Cuts to older people’s home care means hospitals have become dangerously full; and cuts to nurse training places have seen the hiring of expensive agency staff put a drain on resources.

As a result, a government with the laudable aim of reducing hospital deaths by 11,000, is now presiding over hospitals that are full of sick patients in overstretched medical units that will inevitably contribute to further avoidable deaths. Tragically, Ministers are taking a huge gamble with the future of our NHS, with no plans to tackle the financial crisis facing hospitals or address the funding black hole in social care.

Lord Phil Hunt of Kings Heath is Shadow Health Minister in the House of Lords. He tweets @LordPhilofBrum

Published 15th March 2016

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