NHS Hits Breaking Point as Patients Overwhelm A&E Services

The NHS is suffering an Accident & Emergency crisis this week, with five hospitals having to declare states of emergency after being overwhelmed by demand. One official described the scenes at some hospitals as a “war-zone”, as patients were left in ambulances queued outside, or languishing on trolleys in hallways. People are being warned to stay away from Accident and Emergency centres unless their situation is critical.

Five hospitals across England: Gloucestershire Royal, Cheltenham General, Scarborough Hospital, Royal Stoke, and Norfolk and Norwich have all declared “major incidents” over the last week, according to the Daily Mail, and have cancelled all but the most urgent operations.

The status is usually reserved for emergencies such as major road or rail accidents which flood A&E departments with casualties, but in this case it was the sheer weight of demand that prompted the declaration, as patients, unable to get appointments with their GPs, turn to hospitals instead.

The crisis has been building for a number of years, thanks to Labour’s changes to GPs’ contracts which removed from them the obligation to offer an out of hours service – a decision that was not reversed by the coalition government, thanks to pressure from doctors unions.

A&E attendances are 5 percent higher this year than in the same period last year, with 284,685 people turning up to be treated, 110,601 of who were admitted. Hospitals have also missed their target to attend to 95 percent of patients within four hours for the 72nd week in a row. The last time hospitals’ performance was this bad was a decade ago.

Sarah Pinto-Duschinsky, director of operations and delivery for NHS England, said: “Unsurprisingly this [the record admissions] is leading to extra pressures on our A&Es. The NHS is pulling out all the stops, with local hospitals, ambulances, GPs, home health services and local councils all working hard to open extra beds and seven-day services using the extra winter funding that has been made available.”

But at the Royal Blackburn Hospital, Lancashire, 18 ambulances were seen queueing to get into the hospital. Once inside paramedics were having to wait with patients as there were too few nursing staff to attend to them, meaning that they couldn’t go back out to answer further 999 calls. One paramedic, who wished to remain anonymous, told the Mail that the hospital simply didn’t have enough beds or staff to cope with demand.

The scene was similar elsewhere. Harvey Thomas, a six year old boy from Shropshire who suffers from cerebral palsy and autism was left sitting with his mother and two siblings in an ambulance outside Wrexham Maelor Hospital in North Wales for three hours after having a seizure in the early hours of the new year.

His mother Eleri told the Mail that she called 999 at 5am, and they were picked up in an ambulance twenty minutes later. “Once we got in, one of the nurses in A&E asked me, ‘If this happened at 5am, why did you only just bring him in now?’ Next time I don’t think I’ll bother with the ambulance. If I’m going to be waiting a long time if there’s no beds, there’s no point.”

Another patient, a 35 year old woman admitted to Gloucester Hospital for gynaecological problems, described the frighteningly chaotic scenes that she witness there after being referred by an out of hours service: “I got to Gloucester A&E at 10pm and had to wait for more than three hours,” she said.

“There were around 60 people waiting including those who were really old or really unwell. Nurses were seeing patients and then sending them back to the waiting room. When I was finally seen I was given a bed in a day surgery unit that should not have even had patients at that time.

“There were only two nurses attending more than 30 patients in the unit. People were screaming in agony and throwing up. One man was repeatedly vomiting and no one came. Another lady removed her own cannula as she got so fed up of waiting. She just asked the lady next to her for a napkin and pulled it out. The nurses did not even notice that she had left.

“The nurses did not hide their displeasure. The woman in the bed next to me had to ask for pain relief, as she had Crohn’s Disease, and the nurse turned round and snapped “I’m getting it”. The kitchen did not even know people were in there. Our breakfast was really late and they left the lunch tray at the end of my bed so I had to hand out food to other patients at lunchtime.

“No one was doing observations. They were still doing the morning drugs round at 3pm. It was terrible. I had to repeatedly ask for my medication so I could be discharged. My brother had to follow the nurses down the hall to ask several times.

“I did not feel safe. I probably should have stayed in another night but I felt it was safer to go home and see my GP. I think lives were put at risk. I have never seen anything like it in my life.”

Gloucester Trust has blamed people who attend for non-urgent ailments for the situation, saying that 30 percent of those who came to A&E could have been treated elsewhere.

Dr Helen Miller, clinical chair of NHS Gloucestershire Clinical Commissioning Group, said: “It is really important to remember that hospital emergency departments are designed to treat serious injuries and emergencies. The choice of healthcare options is often greater than people realise, particularly for the treatment of minor ailments.”

Susan Field, Director of Service Transformation at Gloucestershire Care Services NHS Trust, which runs the county’s community hospitals and its community nursing service, added: “We have minor injury units at all seven of our community hospital sites where we can treat a wide range of conditions and would encourage people to use these where possible as an alternative to A&E.

“We will continue to respond to the increased demand that we are all experiencing and that this means continuously working with patients and their families to ensure they are discharged at the earliest possible opportunity to maximise the availability of services and beds.

“Our community services and integrated community teams, including our Rapid Response service, will continue to work closely with GPs across the county to help ensure people are able to recover in their own homes instead of going to a hospital unnecessarily.”


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