You attribute A&E delays partly to frivolous use of services by patients; but “too many people attending A&E” does not explain the winter crisis. Higher numbers attended A&E in June and July, yet cases meeting the four-hour performance target stayed above 92 per cent, compared with the first week in December when it dropped to 87.7 per cent.
The real explanation is the mismatch between the rising trend of hospital admissions and the cut in the number of acute beds, as evidenced by the dramatic increase in the number of people spending between four and 12 hours on trolleys before a bed is found. As admissions increase, delays in transferring patients to beds cause pressure in A&E and the four-hour performance falls. The beds shortage is compounded by delayed discharge from hospital due to social services cuts: delayed discharge figures for October were the highest since data collection started in 2010.
The impact on remaining A&Es is horrendous. Emergency doctors in Ealing describe arriving for a shift and being greeted with the words “there are no beds”. Staff spend precious time running around trying to set up beds in any corner they can find. Patients waiting for hours on trolleys risk deterioration.
This crisis was predictable and should have been planned for with proper investment. Instead we’ve had £20 billion “efficiency savings” in the past five years and another £30 billion to come, A&Es have been closed and hospital, community, GP, mental- health and social-care budgets cut.
The £700 million that the Government is throwing at the problem is intended to avert political embarrassment before an election. It’s too little, too late and unlikely to have much impact on the conditions for patients or staff in A&Es this winter.
Dr Louise Irvine, Lewisham GP, National Health Action Party
In its clinical strategy paper, made public and discussed at its board meeting on July 30, Imperial College Healthcare NHS Trust says it will sell 55 per cent of the land at Charing Cross Hospital but can’t say which 55 per cent. And who is it that property developers are talking to? Imperial denies discussion with developers.
The trust is still not clear what hospital provision will be at Charing Cross or Ealing once its strategy is implemented, or how it will be staffed.
There is no evidence that so-called out-of-hospital services will reduce the present need for blue-light A&E services and acute inpatient beds. Hospitals in north-west London are already breaching ambulance target times at an unprecedented rate, falling significantly compared to other NHS areas since the closure of Hammersmith and Central Middlesex A&Es in September.
We demand a moratorium on further closures and reorganisations and a new consultation rather than pie-in-the-sky/we’ll-know-some-day proposals for local health care.
Merril Hammer, chair, Save Our Hospitals: Hammersmith and Charing Cross