A&E Review

A&E Review

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By James Billot

On January 3rd, Secretary of Health Jeremy Hunt was forced to apologise to patients in England who had their operations postponed over the Winter break. To exacerbate the issue further, the 2017/18 Winter period has seen an eighteen-fold increase in the number of A&E patients waiting for more than 12 hours in emergency departments since 2015/16. For Hunt, who stated that the Secretary of Health’s position is likely to be his “last major job in politics,” is now left with his legacy at stake.

The Winter season is always the most taxing period of the year for hospitals. It is during this period that flu is at its most prevalent and demand for care is at a peak. Last year’s Christmas period proved to be no different; understaffed and overworked, the NHS struggled to cope with the huge influx of patients across the UK.

NHS December figures show that only 77.1% of ‘type 1’ attendances (consultant led 24-hour service with full resuscitation facilities and designated accommodation) in England’s A&E units were handled within the four-hour target. While Scotland’s A&E units performed marginally better at 82.3%, both countries fell short of the desired target of 95% for patients to be admitted, transferred or discharged within four hours.

The outbreak of the H3N2 strain, or the ‘Aussie flu’, has contributed to the huge spike in NHS patient admissions. According to Flusurvey; an online survey that monitors trends of flu-like symptoms in communities, the vast proportion of the UK’s communities has been suffering from flu-like symptoms over the Winter period. Flu outbreak in 2017/18 has already forced an additional £1 million per day of spending on agency or non-permanent staff and based on a report by NHS Improvement, a total of £2.9 billion was spent on temporary staff last year.

Dr Chris Moulton, Vice President of the Royal College of Emergency Medicine, said: “These figures show Government interventions to try to avert the winter crisis have been too little too late. We know winter is coming every year. The whole system is gridlocked. We are portrayed as a group of spendthrift doctors calling for more resources all the time, but we don’t need many more resources. The first thing we need is enough beds.”

Dr Moulton raises a legitimate concern; over the past seven years, a total of 12,000 acute hospital beds have been lost and compared to other European countries, the UK has far fewer hospital beds as spending has decreased from last year. In Western European countries, there is an average of four bed per thousand, but in the UK, there is only 2.6.

Prime Minister Theresa has flatly denied claims that the NHS is in a state of crisis, but the deteriorating conditions and growing dependence on external agency support seem to suggest otherwise. 2018 will be a critical year for both Theresa May and her government to provide fast-acting solutions to a health service that is on the brink of disarray.

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