Fears over NHS crisis resilience

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Published: Friday 19th December 2014 by The News Editor

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The NHS’s resilience to a winter crisis has been reduced because the service is being permanently run “at a crisis basis”, a doctors’ leader has warned.

Mark Porter, the chairman of the British Medical Association (BMA), said that the NHS in England was facing the highest level of emergency admissions in its history, and that staff were having to work “flat-out” simply to cope with demand.

A senior NHS England official acknowledged that the service was facing “a tough winter” which could see patients waiting longer than the four-hour target in A&E, as well as the cancellation of non-emergency operations.

But Barbara Hakin, the national director of commissioning operations for NHS England, insisted she is “confident” that the vast majority of patients would continue to be seen quickly and safely, thanks in part to a £700 million injection of funds that will see more doctors, nurses and beds come onto the wards during the winter months.

She urged patients to help ease the pressure by seeking help from GPs, pharmacists and the non-emergency 111 helpline, if their condition is not genuinely urgent.

“Don’t go to A&E, don’t call an ambulance, unless that’s what you really need,” she said.

Dr Porter told BBC Radio 4’s Today programme: “We’ve seen record numbers of patients waiting longer for treatment in emergency departments. We’ve seen emergency admissions at the highest they’ve been since records began.

“But to me, the most important thing is really that the entire system is being run at a crisis basis simply in order to keep up with our existing work.

“That means, of course, that our resilience to a further crisis – a winter crisis, or anything else laid on top of it – is reduced because everybody is at the present time working the system flat-out to serve patients.”

Dr Hakin told the programme: “Dr Porter is certainly right that the NHS is under a lot of pressure. Last week we saw 440,000 patients in our A&E departments, which is 24,000 more than the same week last year.

“But what I’m also sure of is that all of us working in the NHS, particularly all the staff out there on the front line, are working flat-out to make sure that patients get a safe service.”

She added: “We will have a tough winter and there may be times when patients wait longer than we want them to, or the standards we set for ourselves.”

Asked whether non-emergency operations may have to be cancelled, she said: “That’s always a possibility.

“Our absolute priority is dealing with patients who need care urgently, making sure we prioritise, making sure that quality and safety are at the top of the agenda.

“We hope that the cancellation of operations will be at an absolute minimum, but if we see a rise in influenza or norovirus – the virus that causes sickness and diarrhoea – then obviously we have to adjust capacity to make sure that our staff are there for those who most need it.

“We plan for these situations. The NHS plans all year round for winter and has plans in place for when you have that extra problem like influenza.

“We have plans in place to deal with whatever scenario arises for the NHS, and I’m confident that as the extra staff and beds come on-stream, we will be prepared, we will be ready to make sure that the vast majority of patients are seen very quickly, that all patients are seen safely and the quality is higher.

“It may well be that some have to wait slightly longer than we would have wanted. But as I say, our absolute priority is quality and safety.”

Dr Hakin added: ” We’ve recently put extra capacity into the system. A&E tends to be the barometer of what’s happening. When the urgent care system is stretched, the A&E department is where we see the waiting times longer than we would like them to be.

“It is important to remember that nine out of 10 patients in England are not just seen within four hours, but treated, admitted or discharged within four hours, which is the highest standard of anywhere in the western world.

“We set ourselves very, very high standards for waiting times to see patients when they are urgently ill. Our standard is that 95% of patients should be seen in that time, but at the moment we are only achieving around 90%.

“And we’ve got lots of extra capacity coming into the system. We’ve put £700 million into the system this year, which has bought extra doctors, extra nurses, extra beds. Many of them have come on-stream.

“These doctors and nurses and beds have been coming on-stream for the last couple of months, but there are more to come through December, January and February because we know that January and February will be tough.”

Published: Friday 19th December 2014 by The News Editor

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