SAM president says ‘fight for better care must go on’

Commenting on today’s release of NHS performance data for February 2017, Dr Mark Holland, president of the Society for Acute Medicine, said:

“Over the last three winters the NHS has witnessed a dramatic decline in its ability to meet performance targets.

“The targets have often been criticised in failing to reflect the granularity of health processes. However, their perceived weakness is in fact their real strength as they provide a global measure of performance and, for targets to be achieved, every wheel and cog needs to be working properly.

“Everything is interlinked; a delayed discharge in a patient waiting for social care deprives a surgical patient of their bed.

“It is a fact that the NHS has less beds than other health economies. It is a fact that we have a workforce crisis, which is especially important, and potentially rate limiting, when sustainability and transformation plans (STPs) are rolled out.

“Then there is data. We should collect data to monitor a system and respond appropriately when we need to make things better. The NHS, however, chooses a different approach. Instead of publishing data contemporaneously, it waits two months for the dust to settle. Sadly the dust never settles. We know that data is available in almost real-time every day of every week, so one can only conclude that such delays are tactical?

“Worse still, the NHS chooses to stop measuring performance, as seen with elective surgery on 31st March 2017. While the performance data is painful for politicians, only patients suffer the true consequences.

“In acute medicine we have a specialty that has been shown to increase discharge rates from hospitals but coupled to reduced readmission rates and improved length of stay. We care for the one in five patients who come to our emergency departments and require admission to hospital. Ultimately, we care for many of the patients seen waiting on trolleys in corridors.

“The four-hour emergency access target was established in response to patients waiting on trolleys in corridors. The time has come to rethink our strategy, but especially to expand specialists in acute medicine to help with the challenges faced by patients requiring urgent admission to our hospitals.

“February 2017 may have been a bit better than January 2017. However, disbanding targets is wrong, especially if it is purely for the sake of improving figures. We fear that people might start to see a 90% achievement of the four-hour emergency access target as the norm, as somehow better than what we saw in January 2017.

“The Society for Acute Medicine argues that as long as we are seeing patients in corridors and as long as we do not have beds in our acute medical units when needed, then the fight for better care must go on.”

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