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Leading doctor ‘fears for hospitals’ as new year dawns

A leading doctor has said he “fears for hospitals” with pressures on the NHS “escalating rapidly” over the festive period.

Dr Nick Scriven, president of the Society for Acute Medicine, said many trusts reported more than 99% capacity in the week before Christmas which “in my view is not compatible with running a safe acute service”.

“Since the bank holiday things have escalated rapidly and we are on the cusp of a major issue at least as bad as last year when it was described by the Red Cross as a humanitarian crisis,” he said.

“There is an awful lot of respiratory illness causing a lot of severe symptoms in the old and young and 10 to 12-hour delays in emergency departments are now not uncommon – along with patients being placed on inappropriate wards.”

Dr Scriven said staff were “working themselves into the ground” at the front door and needed the support of colleagues to “challenge every discharge decision”.

“I fear for acute trusts this next week,” he explained. “Hopefully the weather will stay mild, but there are also some steps trusts can take to try to alleviate pressure that will cause their hospitals to break.

“I would urge trusts to plan for having extra capacity needed for the next fortnight and plan to staff these consistently, as well as boost diagnostic capacity and therapy services for the next two weeks.

“This will enable them to try to catch up with the backlog caused by effectively having seven to 10 days at what were probably ‘bank holiday’ levels.”

Dr Scriven said it was not known how many trusts had taken advice issued by the NHS National Emergency Pressures Panel to cancel elective – non-urgent – surgery in the first two weeks of January, but he suggested this advice should be extended at least until the end of January and possibly to the end of February.

“To be at this point now – with reports of some hospitals even diverting patients between Christmas and New Year when there is traditionally a lull – suggests we may be in desperate times,” he said.

“With us yet to experience any significant infection outbreaks, my belief is that trusts may be wise to consider cancelling some elective surgery until at least the end of January and maybe into February.”

Acute medicine, also known as acute internal medicine, deals with the immediate and early treatment of adult patients with a variety of medical conditions who present to hospital as emergencies.

The specialty receives the majority of patients admitted from A&E and plays a vital role in maintaining the flow of patients through emergency departments to avoid exit block, the term used when patients cannot be moved into a hospital bed.

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