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Leading doctor warns NHS could “break far worse” this winter

A leading doctor has warned the NHS could “break far worse” this winter as the system faces the prospect of a major flu outbreak.

Dr Nick Scriven, president of the Society for Acute Medicine (SAM), said despite much talk nationally of adequate preparations, frontline staff feel there is “nothing new other than crossed fingers”.

He also said elective, or routine, activity “will almost certainly cease for several months” as hospitals struggle to cope with growing pressures as a result of a reduction in the number of beds and the ongoing crisis in social care.

“Over the last two to three years we haven’t had to deal with any major outbreaks of infection such as norovirus or flu, but this year we are predicting a bad flu season that will overwhelm us after what we’ve witnessed in Australia and New Zealand,” he said.

“For all the talk of preparations, on the ground it feels as though there is nothing new this year other than crossed fingers – which is fair comment as the government has failed to tackle effectively the issues behind the pressures we face.”

He added: “If, as we expect, we see a flu outbreak, I think the NHS – in terms of both beds and clinical staff – will break far worse than last year and elective activity will almost certainly cease for several months.”

Dr Scriven pointed to a decline in bed numbers – with an estimate of 5,000 additional beds required to enable the NHS to survive the winter months – delayed discharges and recruitment difficulties as the “determining factors”.

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.

“We constantly see the government roll out the same lines, such as the increasing numbers of patients being treated in the NHS every year and the investment being made in social care,” Dr Scriven said.

“The problem is, how can an argument be made for increasing numbers of patients being handled effectively when the number of beds available is not only not growing but is actually decreasing.

“Added to the ongoing issues of medically-fit patients being unable to be discharged due to a lack of infrastructure, we face turmoil if the system comes under pressure it simply does not have the capacity to sustain.”

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