Breaking point: Inside the NHS’s looming crisis

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TeaThe NHS is facing its toughest winter, as rising cases of the coronavirus combine with increased demand for A&E and a healthcare system brought to its knees under the pressure of an unrelenting 18-month pandemic.

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While ministers including Health Secretary Sajid Javid have claimed that the resurgence of Covid has not put continued pressure on the NHS, doctors, nurses and health officials across the country have told Granthshala The escalating crisis on several fronts means that the healthcare system is facing a very real catastrophe.

With daily coronavirus infections at 50,000 and the number of patients admitted to hospitals every day nearing 1,000, the chairman of the government’s Covid modeling committee, Professor Graham Medley, said the country could be “three or four weeks away” from a serious problem. if the growth remains uncontrolled.


Leaked modeling shows that A&E departments also face alarming levels of congestion in the coming months, with 60,000 more patients a week.

As one NHS chief suggested Mr. Javid was living in a “parallel universe”, Granthshala met:

  • The Royal College of Emergency Medicine is warning it will be “the hardest winter the NHS has ever had”;
  • According to the Intensive Care Society, intensive care beds are lying vacant up and down the country due to a shortage of nurses;
  • A sick two-year-old girl was forced to sleep on two chairs in a waiting room during a 14-hour A&E wait;
  • A hospital is to start returning non-emergency patients to A&E from Monday;
  • A leaked survey of more than 114 NHS surgical teams found that two-thirds have reduced operations, with about a fifth unable to perform a hip replacement;
  • The military has been called in to support three hospitals in Scotland as the area goes on a “black alert” level; And
  • NHS data shows that patients are staying in hospital for longer periods because community services cannot be provided to care for them.
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Graham Medley, chairman of Spi-M, the government’s scientific committee modeling the spread of Covid-19, told Granthshala That, while there was enormous uncertainty about the progress of Covid-19, the situation was not far from a turning point.

The Professor of Infectious Disease Modeling at the London School of Hygiene and Tropical Medicine said infections and hospital admissions across the country were below expected levels, but added: “Clearly, we ‘hope’ if they continue to rise.” And then potentially we ‘expect’, but they have to keep moving, and at current rates of growth, we’re about three or four weeks away from getting into areas like that that may be related.

“Doubling what we have at the moment is going to cause more than double the problems and at the current rate, if that doesn’t change, we are three or four weeks away from doubling.”

A major concern for ministers is the risk of eroding immunity among vulnerable groups, which were quickly stifled – many reaching the point when it is believed that vaccine protection is diminished. This puts them at greater risk at a time when more than a million people are infected, according to the latest Office for National Statistics survey.

Prof Medley said: “The other big driver is the behaviour, which people do, and that is certainly unpredictable and that is where a lot of the uncertainty comes from.

“If things go horribly wrong, with a lot of mixing and phenomena going much faster than we expected, things can still go awry.

“I am relatively optimistic. We are seeing growth now, but I think immunity will prevail.”

On Friday, scientists in the minutes of the Sage group of government advisors warned ministers to begin preparing their “Plan B” to deal with the increased spread. Professor Medley said: “I think it’s absolutely true that the science is pretty clear that acting early certainly does reduce the risk of acting harder later.”

The latest modeling summary, published Friday by the SPI-M committee, said: “This leads to both rapid increases in transmission rates and repeated lack of protection from vaccinations to an order of magnitude of those leading to hospital admissions levels.” Will go. January 2021.”

But it added: “Many of the modeled scenarios have extended periods with higher numbers of hospital admissions. Even if peak admissions levels remain well below January 2021, it may still be associated with health and well-being.” could put care settings under significant pressure, especially if it coincides with high numbers of patients with other respiratory infections that have not been modeled.”

Weekly admissions to hospitals have now reached a seven-month high and the NHS is already facing many problems despite Covid-19.

‘The hardest winter’

More than 160 patients crowded into the Royal Stoke University Hospital A&E department on Wednesday night, as footage emerged of ambulances parked outside the hospital waiting to be handed over to patients. This scenario is repeated throughout the summer across the country.

Patients at Plymouth Hospital on Wednesday night faced a seven-hour wait to see a doctor and in Cornwall, where owners have declared a serious incident this week, a patient spent more than 13 hours in the hospital Waited with paramedics. A&E patients in Preston routinely have to wait nearly 50 hours for a hospital bed.

Granthshala has seen internal modeling leaked from NHS England, showing that the increase in A&E attendance could be worse, with predictions of 350,000 patients a week across the country in April – 60,000 per week compared to June. week more.

An NHS England document said such an increase would mean an additional 60 patients a day in a 24-hour A&E unit, 15 to 20 of whom would need beds, warning of a “significant impact” on congestion And routine surgery on a knock-on effect.

Modeling forecasts from NHS England outlining expected growth in A&E attendance

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Modeling forecast from NHS England outlining expected growth in A&E attendance

Dr Katherine Henderson, President of the Royal College of Emergency Medicine Granthshala: “Even before the pandemic, emergency departments were struggling, which resulted in reduced resources. Now we get into what will be the hardest winter the NHS has ever had. “

Some hospitals are now planning to take back patients who do not have life-threatening illnesses or injuries. Starting Monday, Arrow Park Hospital in Merseyside, is to test a system where any non-emergency case will be referred to options such as walk-in centres, GPs or pharmacies. After a 5 percent increase in A&E attendance in the first eight months of 2021 compared to 2019, the trust said it expects the stance to cut long waits.

data viewed by Granthshala West Midlands Ambulance Service shows that 5,752 ambulances waited more than 60 minutes to hand over patients to A&E staff at hospitals across the region in September. The ambulance handover is to be completed within 15 minutes so that the paramedics can return to waiting for 999 emergencies.

Heartland Hospital in Bordesley Green, Birmingham, was the worst site for handover delays, with 629 delays lasting over an hour. Royal Stoke Hospital was second with 618 delays.

‘Everyone is in their own little nightmare’

David Barker, 36, of Stoke-on-Trent, knows exactly what an overwhelmed NHS looks like. Their two-year-old daughter, Violet, had to sleep on two chairs in the A&E department at the Royal Stoke Hospital earlier this month.

The girl was taken to the hospital after she was unable to eat and drink and had difficulty breathing. Mr. Barker said he and his daughter waited 14 hours at A&E on October 15 before Violet was finally given bed and treatment in a children’s evaluation unit.

He said: “They kept saying ‘we’re trying to find you a room’ and we had been there for 12 hours until this stage. So in the end I pushed two chairs together to make a makeshift bed so that Violet Could sleep

“Although the NHS is wonderful, and something to cherish, its processes are broken. You can see the staff were under pressure in every way. You’re in that room and you can hear all the conversation around you, like that Seems like everyone is in their own little nightmare.

Violet Barker was sleeping on a makeshift bed at the Royal Stoke Hospital last week

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Violet Barker was sleeping on a makeshift bed at the Royal Stoke Hospital last week

Mr Barker said he had taken a picture so people could understand and see for themselves how bad things were. The next day after treatment, Violet was allowed to go home.

Enabling the “flow” of patients out of A&E and into the ward is an important aspect of any hospital’s daily operations. But they have to provide beds.

Over 8,000 beds have been occupied with Covid patients as hospitals have had to reorganize wards to keep non-Covid patients free from infection. This means more bed closures.

‘There are empty intensive care beds up and down the country’

During the height of the pandemic, NHS intensive care units were on the front lines in the fight against Covid-19 and services expanded rapidly, sometimes doubling or tripling the normal number of beds. Intensive care nurses were spread out among many patients.

At the time, experts warned that the critical care nursing workforce was working…


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