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Prime Minister’s NHS winter funding “welcome but of limited benefit” says SAM past president

Following Prime Minister Boris Johnson’s announcement that NHS trusts across England are to receive £300 million to upgrade their facilities ahead of winter amid fears of a second wave of coronavirus, Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said:

“While any funding is helpful, there are limits to how this will actually be of benefit over the next few months.

“We know our units involved in acute and urgent care, whether they be emergency departments or our acute medical units and surgical assessment units, are all anxious about how they can see patients and keep them ‘covid secure’.

“This funding seems earmarked for the EDs but that will not help the others and we know that up to 40% of those people who need an acute medical bed do not actually enter the hospital via the ED.

“It is imperative that any work done in the EDs must not disadvantage these people when it comes to acute care.

“Emergency departments depend on flow into our assessment units and same day care areas and we need these to develop their safe infrastructure just as much as the EDs do but, in general, these areas are not seen centrally as such a priority.

“This is largely because a lot of the work they do, although just as vital, is “hidden“ from targets. Acute medical units and staff have been working under the pressures seen in our emergency departments and the staff and patients they treat need the same care and safety.

“Secondly, we know that staffing is as much of an issue as estate and this will not help that. Staff of all trades and grades are already working themselves into a state of semi-exhaustion and with the prospect of winter to come, potentially only weeks away, many are worried on the capacity they will have left to do their jobs.

“Lastly, and most pragmatically, the money is welcome but how do we think we can actually implement what would be building works in existing units whilst remaining safe and efficient – all before any rise in either covid or non covid patients which, if like last winter, may start before the end of October?”

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Late emergency presentations ‘even more likely’ with reduced access to healthcare professionals

Dr Nick Scriven, immediate past president of the Society for Acute Medicine, comments on the release today of the Royal College of Physicians’ fifth survey of fellows and members which shows that doctors are concerned for patients as practice and rotas return to normal.

He said: “We have seen far too many times in the recent past patients with severe conditions attending hospitals or referred to same day emergency care units as they have possibly underplayed their own problems and there has been no healthcare professional checking them.

“This is even more likely to happen in the ‘new normal’ of patients not actually seeing their GPs and relying on telephone consultations.

“Hospitals are running at reduced capacity to maintain the ‘Covid-secure’ environment and with much reduced diagnostics so it is, in my opinion, a folorn hope to get everything back to 90% of capacity swiftly as NHS trusts have been tasked with.

“The numbers of patients seeking urgent care has been well below what we would expect for this time of the year and more than 50% of patients are waiting more than six weeks for a diagnostic test which is gravely concerning.

“The ‘Covid-safe’ capacity is just not there and it seems to be forgotten that acute patients are returning in numbers and also needing access to diagnostics.

“I think one of the crucial things is whether or not community-based services designed to keep people safe from their chronic disease have been working.

“For example, heart failure community teams not working/redeployed into busy hospitals mean patients gradually deteriorating at home and now in far worse conditions.”

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Health secretary’s “busting bureaucracy” plans will not reverse decades of bed reductions

Following comments made by health Secretary Matt Hancock in today’s media regarding a a “bureaucracy busting” to coincide with the latest installment of the NHS People Plan, Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said:

“Whilst I welcome anything that puts staff wellbeing at the forefront of plans, “busting bureaucracy” will not reverse the decades of bed reductions that have exacerbated pressure over the last pre-pandemic years of the “eternal winter”.

“Staff will welcome anything that makes doing their jobs of caring for people easier but technology is not always the answer.“

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NHS funding ‘welcome but more than sticking plasters needed’, say senior medics

Following the Prime Minister’s announcement today of a £3bn investment in the NHS to prepare for a possible second wave of coronavirus and to help ease winter pressures, Dr Susan Crossland, president of the Society for Acute Medicine (SAM), said:

”While this funding announcement is welcome, the government is constantly playing catch up with its funding of the NHS, often providing sticking plasters due to long-term neglect in terms of investment in staffing and infrastructure as well as social care provision.

“The squeeze on acute and emergency care has suffered from all of the above and notably the total number of beds in England, which has more than halved over the past 30 years overall and by 34% in general and acute beds.

“It is therefore no surprise we see overnight bed occupancy constantly well above safe levels in winter at more than 95% and this will be a major area of focus this year in particular with the additional threat of a second wave of Covid.“

Dr Nick Scriven, immediate past president of SAM, added: “Along with the Royal College of Physicians, the Royal College of GPs and the Royal College of Emergency Medicine, we this week released 10 recommendations which we hope the government and NHS leaders think about seriously.

“We are also pushing the advantages of same day emergency care (SDEC) which we estimate could potentially save more than 50,000 overnight admissions over autumn and winter if just a third of patients receive their first assessment in SDEC.

“This is a prime time to start looking at how we can make better use of the innovations already available to us and SDEC presents a simple but effective solution to bed capacity – but it requires investment and a national commitment to drive it forward and this announcement opens up the possibility of us progressing in this area.”

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Rebuilding the NHS, improving medical pathways for acute care

The Royal College of Emergency Medicine (RCEM), Royal College of General Practitioners (RCGP), Royal College of Physicians (RCP) and the Society for Acute Medicine (SAM) make recommendations for the immediate transformation of the urgent and emergency care pathway.

As the COVID-19 pandemic continues, the public must be confident that they will receive urgent and emergency care in a safe environment. That care must be timely and delivered on the basis of clinical need, whether by primary or secondary care services.

Pandemic infection prevention and control measures are complex and must be addressed proactively. RCEM, RCGP, RCP and SAM believe that transformation of the urgent and emergency care pathway is needed now. Without it there will be crowding, which is dangerous for patients and carers, and makes infection prevention and control impossible.

In this statement, we set out some principles and make 10 recommendations. These changes will only be possible if all of us continue to work together. We are encouraged by the increase in multispecialty working during the pandemic and are committed to helping it continue.

To discuss anything in this statement, or for more information, please contact us via policy@rcem.ac.uk, policy@rcgp.org.uk, policy@rcplondon.ac.uk or communications@acutemedicine.org.uk.

Please find the document below:

Improving medical pathways for acute care

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SAM immediate past president “very concerned” at access to diagnostic tests

Following the release today of a range of NHS performance data for May and June, including diagnostic waiting times, Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said:

“Clearly NHS performance across the board continues to be hugely affected by Covid-19, though we must also remember performance has been poor for a lot longer than that and questions need to be answered as to how we ensure the sustainable future of the service.

“We are very concerned about the growing crisis in accessing diagnostic tests, with the total number of patients waiting six weeks or more from referral for one of the 15 key tests at 571,500 – 58.5% of the total number of patients waiting – which is shocking given the target is 1%.”

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Withholding funds promised to NHS “not right” says SAM past president

Following information obtained by The Observer concerning a dispute between NHS England and the Treasury over the release of funds to cover the additional costs of managing the coronavirus pandemic, Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said:

“It would be a shame if the funding that seemed to be promised is now being attached to various measures and outcomes that were not in place when the initial announcement was made.

“Of course funding needs to result in appropriate activity, but to tie money up that is really needed to get acute and urgent services through the next few months with elective surgical output in appropriated private hospitals does not feel right.

“I totally agree with recent comments from Chris Hopson of NHS Providers on that the government needs to follow its own advice and ‘protect the NHS’, which is there for everyone whether or not a pandemic is present and relies on the multitude of staff who have put the service ahead of any personal concerns to look after people as always.”

For the full story, which appears in today’s Observer, visit www.theguardian.com/society/2020/jul/04/nhs-chiefs-in-standoff-with-treasury-over-emergency-10bn

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SAM submission to Health and Social Care Committee’s pandemic inquiry

The Society for Acute Medicine has made a submission to the Health and Social Care Committee’s ‘Delivering Core NHS and Care Services during the Pandemic and Beyond’ inquiry ahead of its latest evidence session today (Tuesday, 16 June).

In the letter, available to download here (Health and Social Care Committee submission), Dr Susan Crossland, president of SAM, and Dr Nick Scriven, immediate past president of SAM, state:

• During the current pandemic we suspect we have seen and treated far more patients with proven Covid-19, alongside our usual non-Covid patients, than either emergency medicine or intensive care medicine, and face equally urgent and daunting issues in providing a return to ‘normal’ working.

• Our three main areas of concern moving forward are the staffing we need to function safely, the bed capacity we have to provide the care we need to and how to safely restart the Same Day Emergency Care activities crucial to keeping patients out of hospital.

• Over the course of the pandemic much SDEC activity has been displaced or is not presenting at all and we now need to try to restart services catering for those without Covid as well as those who may have Covid or are asymptomatic. This will need major revisions in estate, staffing, diagnostic service availability and protocols.

• We are very aware of the problems we face with those who need an inpatient assessment bed. There needs to be significant work to try to prevent a return to the issues we have all seen in emergency departments with crowding.

• Like emergency departments, our units will need to be configured to allow safe and timely admission of patients not only from ED but also direct from primary care with routes disadvantaging neither. With the constant focus on ED there is a significant risk to those from other sources of referral (up to 40% of patients from our SAMBA audit 2019) being disadvantaged.

• We all need to work together for the best interests of patients and ensure that patient care is always considered above any arbitrary time based target or ‘date stamp’ saying that one area has ‘completed what they need to’ and to move the patient onwards regardless of the receiving areas’ pressures.

• Staffing for us moving forwards is a real and ongoing worry. As a highly skilled workforce in terms of acute care skills, our established teams have often been seen as a source of help for other areas and many of our nurses have been redeployed to ICU, ED and respiratory units to bolster those areas. This meant our teams not only having to cope with Covid patients but also to train up teams of nurses deployed into our acute areas from their normal jobs in areas such as outpatients or cancer screening.

• Our remaining teams have worked wonders, often in the same physically draining PPE as ED and ICU over the last months and now need help. We are acutely aware that winter is not too far away and senior figures are already warning us how ‘bad’ it will be. We urgently need our staff to be returned to us so that we all have enough time over the next few weeks to give everyone a chance to draw breath and recharge our batteries.

They concluded: “We recognise the immense effort that the whole of the NHS has achieved over the last few weeks and this should not be forgotten as we head towards the ’new normal’. As experts in acute care we feel that our contribution going forwards will be invaluable.”

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Fears for NHS with “scarce sign“ of recovery plan, says SAM past president

Following today’s release of NHS performance data for May, Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said:

“This data highlights the capacity we need to work in “normal” circumstances given that the NHS is only close to reaching the four-hour A&E target because attendances are down 42%.

“We really do fear for the health service over the remainder of the year given the increasing evidence of the mishandling of the pandemic and as yet scarce sign of any meaningful recovery plan.

“The numbers of patients seeking urgent care has been well below what we would expect for this time of the year, more than 50% of patients are waiting more than six weeks for a diagnostic test and, combined with the postponement of much planned treatment, it is a potent mix.

“This could have significant consequences for both patients and hospitals as we adapt to the pressures of Covid and Covid-free working.

“Exhausted staff are doing their utmost to adapt to the demands of this whilst trying to continue keep up with changing policies that seem to be announced last thing on a Friday.”

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Senior medics call for urgent preparations for “winter like no other” in the NHS

Senior medics have called for urgent preparations to be put in place now to contend with a “winter like no other” in the NHS this year as hospitals face the prospect of managing COVID-19 alongside seasonal viruses and other pressures.

Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said action was needed to “protect staff so they can continue to care for patients” ahead of what he anticipates will be an “onslaught”.

He warned that concerns raised by senior government advisers about a second wave of COVID-19 combined with seasonal viruses, the effects of delayed presentations and worn out staff could have “severe consequences.”

“The greatest concern now is around the coming autumn and winter and we have already heard senior scientific and medical advisers Sir Patrick Vallance and Dr Jenny Harries say that winter will be extremely challenging for the NHS.

“In particular that we may have a second wave of COVID-19 simultaneously with the usual seasonal rise in other viral illnesses such as influenza and norovirus together with all of those who have put off coming to hospitals as long as they possibly could during the first wave.

“These predictable stresses will be further exacerbated by the ongoing need to keep people with coronavirus separate from others to prevent transmission, with segregated wards effectively reducing immediately available beds.”

Dr Scriven said part of the planning strategy should look at a permanent reduction in the footfall through hospitals to help maintain focus on the importance of infection control as a significant part of the effective running of hospitals all year round.

“Positively, the recent and current focus on infection control and distancing can only help reduce the spread of infections associated with the high attendance, footfall and high bed occupancy rates we routinely see, particularly so during winter.

“The current reduced bed use in some areas help to reduce the spread of infection but the clock is ticking on that option as we move through the year, so we need to think about what measures will be incorporated into planning now for what will be a likely horrendous end of the year.

“As part of this, in addition to the reduction in activity through telephone and online outpatient clinics, I would strongly urge permanent reduction in unnecessary footfall in hospitals from large groups of visitors, on-site meetings, conferences and public events.

“We know influenza and norovirus spread at will through hospitals following community transmission, so looking at how we can take some of the current changes forward permanently would be a positive step towards reducing infection and, in turn, pressures on hospitals and staff.”

Dr Scriven said it was also imperative government and NHS leaders recognise the “neglect” of staffing levels and what steps will be taken to care for the wellbeing of staff.

“As we move through the pandemic we need to consider what comes next and we must work out – and see evidence – of how we will give our front door teams much needed time to recover both tired minds and bodies.

“We need government and hospitals trusts to act now and recognise that through immense efforts the NHS has managed to look after many thousands of people, but this has only been made possible through mass changes and cancellations affecting planned care.

“The problems likely to be associated with that could be exacerbated by a winter like no other which, coming after years which have seen each winter be labelled the “worst ever” could have severe consequences.

“We need to see urgent action to protect staff so they can continue to look after all of those in need when they need it as the NHS is for life, not just a pandemic.“

Dr Susan Crossland, president of SAM, added: “There is a cautious welcome that the initial wave has been controlled and things feel a little more like normal but the threat of winter, flu, norovirus and coronavirus means that we need to be better prepared than ever – and that is something we haven’t been for a number of years now.”

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Top doctor urges PM to stop playing “fast and loose” with data

Following today Prime Minister’s Questions, Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said: “Despite all the PM’s rhetoric about protecting the NHS, his government’s mishandling will harm the very people he is purporting to have protected by risking them coming under intense strain in the coming weeks and months with no let up or recovery time.

“We are also gravely concerned about increasing lack of transparency in crucial decision making and playing “fast and loose” with data that seems to be presented to support a pre-ordained narrative rather than the reverse which would be “normal” in any other situation.”

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SAM ELECTIONS 2020 – CALL FOR APPLICANTS

SAM ELECTIONS 2020 – CALL FOR APPLICANTS

SAM ELECTIONS 2020 – CALL FOR APPLICANTS

Dear SAM member,

In accordance with the Society’s Articles of Association certain posts are now up for election. This has been an extraordinary time for all of us within Acute Medicine and our Society more than ever is grateful for your support. These posts will give you an opportunity to help us develop the society and support our members during what is likely to be an interesting and at times challenging period as we now embrace working within the “new normal”.

We are now seeking applications for the following roles with SAM (council members):

  • 4 Regional representatives: England, Northern Ireland, Scotland, and Wales
  • Trainee representative
  • Allied Health Professional
  • Advance Care Practitioner (includes Advanced Nurse Practitioner)

We are also seeking applications for the following posts. These roles will not have formal seats on council but will be co-opted to attend some meetings and have a place on the relevant committee.

  • Quality and Innovation Committee Lead (1 post)
  • Training and Education Committee Consultant Member (1 post)
  • Research Committee UK Member (2 posts)
  • Research Committee non-UK Member (1 post)

We are looking for applicants who are passionate about acute medicine, new ways of working, sustaining safe and effective care, and the development of the specialty and the multi-professional group of healthcare professionals who work in acute medicine.

Attached to this letter are the job descriptions for each post. The posts are open to SAM members.

If more than one application is received for the role of Regional Representatives, Trainee representative, Allied Health Professional and Advanced Care Practitioner, an election shall be held.

If more than one candidate applies for QI committee lead or Training and Education lead, Council directors will appoint the best candidate.

If there are more candidates than posts for the research committee roles, directors, along with the Research Lead will appoint the best candidate.

Applications should be made electronically to the Society’s office by midday on Friday 12th June 2020.

Your application must include:

  • A 300 (maximum) word statement to support your candidacy. Statements exceeding the word limited will be returned to you for editing
  • You must be proposed and seconded by two society members who are in good standing with the society
  • You must be in good standing with the society

Please supply contact details including a mechanism to contact you as soon as the results are available.  We prefer to contact all candidates by telephone when possible.

You are very welcome to informally discuss any role with the current post holders or current SAM Office Bearers.  Please get in touch with the SAM office and we’ll get them to call you.

The new post holders will commence duties as soon as the appointment has been ratified by Council in September. We are planning to hold a virtual council meeting on the 15th September for those posts with seats on council.

Yours sincerely,

Dr Vicky Price
Secretary, Society for Acute Medicine

Job Description Regional Representative 

Job_Description Trainee Representative 

Job Description ACP

Job Description AHP

Job Description Quality & Innovation Lead 

Job Description  Training and Education Committee

Job Description Research Committee 

 

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SAM Webinar Resources

Society for Acute Medicine: Virtual Conference Sessions

Weekly series of Clinical Practice Webinars with SAMLondon 2020 Abstract Presentations

Series 1: 20 May – 17 June 2020

Resources from the weekly webinars are available to view with the links below where we receive speaker permission.

20 May 2020: Early Learning from COVID-19 & Acute Kidney Injury & The New Acute Medicine Curriculum

SAM Webinar 1_20 May

Webinar recording

 

27 May 2020: Update on Ongoing Trials in COVID-19 in Acute Medicine & Point of Care Ultrasound in the patient with COVID-19

SAM Webinar 2_27 May – to follow – awaiting speaker update

Beyond Protocol Working; the development of a conceptual framework to further understand clinical decision making in uncertainty (Abstract presented within webinar)

Webinar recording

 

3 June 2020: Insights from ISARIC and ICNARC & Conscious Proning during COVID-19

SAM Webinar 3_3 June

Webinar recording

 

10 June 2020: ACP Acute Medical Curriculum & COVID-19 in Acute Medicine: Clinical Update

SAM Webinar 4_10 June

Webinar recording

 

17 June 2020: COVID-19 in Acute Medicine: Implications for Acute Oncology & Using Apps for patients in Acute Oncology: Safe at home?

To follow – awaiting speaker permission

 

Series 2: 7 July, 18 August, 29 September

7 July 2020: Triage into the Community of COVID 19 – Virtual ward & Management of patients with COVID-19 with an ED led ambulatory pathway

SAM Webinar 7 July

Webinar Recording to follow

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Senior medic says sustained drop in A&E numbers a “ticking timebomb”

Following the release today of A&E performance data for April which shows the lowest number of attendances reported since the collection began, Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said:

“The sustained drop in A&E attendances is a significant concern given that many of those who have put off coming to hospitals as long as they possibly could during the first wave will be seeking treatment and could potentially be in worse conditions.

“This is a ticking timebomb in itself and it will be exacerbated by a myriad of other pressures in the coming weeks as hospitals adapt to running parallel units for infected or possibly infected acute work alongside elective work.

“There will be an ongoing need to keep people with coronavirus separate from others to prevent transmission, with segregated wards effectively reducing immediately available beds, so attempting to manage increased demand will be very challenging.

“I am also highly concerned about the resilience of staff who have been working flat out with little time for recovery, which means they will continue suffer personal sacrifice as we move through the stages of this crisis.”

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Leading doctors criticise “haphazard testing” and call for urgent explanation of track and trace strategy

Following news the UK now has the highest number of coronavirus deaths in Europe, Society for Acute Medicine President Dr Susan Crossland and past president Dr Nick Scriven commented:

“The different ways the cause of death is recorded across Europe (and the US) does make this new data less useful as a comparison.

“However, we do feel that the repeated changes in how data is being calculated does lead to confusion and lessens any messages associated with them. It could easily cause general scepticism around any further figures.

“As a Society we are in agreement that the testing strategy employed to date has seemed haphazard in delivering what it could have and has certainly not helped the situation in the way it has been changed.

“The way the figures were apparently “massaged’ on April 30 to hit an arbitrary and self-imposed target helped no one.

“We urgently need the strategy for track and tracing to be openly explained to everyone to make certain any concerns are fully dealt with so they can be implemented as soon as they are needed without endless revision.”

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PRESS RELEASE 27 April 2020

PRESS RELEASE 27 April 2020

SENIOR MEDIC CALLS FOR “SUBSTANCE BEFORE SOUNDBITE” FROM THE GOVERNMENT

 

A senior medic has called for the government to put “substance before soundbite” when it comes to the realities of the effects of COVID-19 on the NHS.

 

Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said despite regular references to creating “spare“ capacity, this was far from an accurate reflection and distracted from the “worrying” long-term picture.

 

“Only a week ago the health secretary stated confidently he has always ensured NHS capacity has met demand but that is quite frankly an absurd manipulation of the truth,” he said.

 

“This type of spin won’t wash as, to be clear, the so-called “capacity“ being described of late has only been made possible because hospitals have adapted to the pandemic and because seriously unwell people have not been seeking medical care.

 

“However, what the reality means is that thousands of planned procedures and appointments have been delayed, while those who have not sought urgent care will be attending hospitals in much worse conditions – so there are consequences.

 

“The utopia of an NHS that has bundles of spare capacity and can cope with anything is a fallacy and to use the pandemic as an opportunity to claim demand has always been met is frankly outrageous.”

 

Dr Scriven said there was growing concern about the pressures on hospitals and staff when non-COVID activity begins to return and COVID patients continue to be cared for by staff who were already stretched long before the pandemic.

 

“As the number of non-COVID patients slowly increases it will strain hospitals who will still need to maintain separate areas for COVID and non-COVID to ensure minimal chance of infection in hospitals and that also means stress on staffing levels which are already stretched.

 

”One of my main concerns is staff resilience. People have now been working outside their usual work patterns or outside their normal hours – often with highly disruptive working hours – for more than a month.

 

“If or when we get either the second wave of COVID and/or a surge in poorly people with other health needs who have so far tried to avoid coming to hospitals, staff will have little reserves unless we see far better staff wellbeing management from the top.”

 

Dr Scriven said that it was not appropriate or fair to “insult people’s intelligence” by making “misleading claims” about the ability of the NHS to manage demand.

 

“Ultimately, despite what rhetoric we hear from the Secretary of State or other ministers or attempts to divert public attention, the pandemic does not wipe out the history books.

 

“The issues that existed long before COVID – chronic underfunding, a crisis in social care, 40,000 nursing vacancies, 10,000 consultant vacancies – are all still present.

 

“What we need is to see is government facing up to the realities of this and delivering comprehensive plans of how it expects to see the NHS manage the return of planned care alongside ongoing COVID presentations combined with pre-existing dilemmas that they’ve still yet to resolve.”

 

Notes

1.) Acute 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 helps maintain the flow of patients through emergency departments to avoid exit block, the term used when patients cannot be moved into a hospital bed.

2.) The Society

SENIOR MEDIC CALLS FOR “SUBSTANCE BEFORE SOUNDBITE” FROM THE GOVERNMENT

 

A senior medic has called for the government to put “substance before soundbite” when it comes to the realities of the effects of COVID-19 on the NHS.

 

Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said despite regular references to creating “spare“ capacity, this was far from an accurate reflection and distracted from the “worrying” long-term picture.

 

“Only a week ago the health secretary stated confidently he has always ensured NHS capacity has met demand but that is quite frankly an absurd manipulation of the truth,” he said.

 

“This type of spin won’t wash as, to be clear, the so-called “capacity“ being described of late has only been made possible because hospitals have adapted to the pandemic and because seriously unwell people have not been seeking medical care.

 

“However, what the reality means is that thousands of planned procedures and appointments have been delayed, while those who have not sought urgent care will be attending hospitals in much worse conditions – so there are consequences.

 

“The utopia of an NHS that has bundles of spare capacity and can cope with anything is a fallacy and to use the pandemic as an opportunity to claim demand has always been met is frankly outrageous.”

 

Dr Scriven said there was growing concern about the pressures on hospitals and staff when non-COVID activity begins to return and COVID patients continue to be cared for by staff who were already stretched long before the pandemic.

 

“As the number of non-COVID patients slowly increases it will strain hospitals who will still need to maintain separate areas for COVID and non-COVID to ensure minimal chance of infection in hospitals and that also means stress on staffing levels which are already stretched.

 

”One of my main concerns is staff resilience. People have now been working outside their usual work patterns or outside their normal hours – often with highly disruptive working hours – for more than a month.

 

“If or when we get either the second wave of COVID and/or a surge in poorly people with other health needs who have so far tried to avoid coming to hospitals, staff will have little reserves unless we see far better staff wellbeing management from the top.”

 

Dr Scriven said that it was not appropriate or fair to “insult people’s intelligence” by making “misleading claims” about the ability of the NHS to manage demand.

 

“Ultimately, despite what rhetoric we hear from the Secretary of State or other ministers or attempts to divert public attention, the pandemic does not wipe out the history books.

 

“The issues that existed long before COVID – chronic underfunding, a crisis in social care, 40,000 nursing vacancies, 10,000 consultant vacancies – are all still present.

 

“What we need is to see is government facing up to the realities of this and delivering comprehensive plans of how it expects to see the NHS manage the return of planned care alongside ongoing COVID presentations combined with pre-existing dilemmas that they’ve still yet to resolve.”

 

Notes

1.) Acute 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 helps maintain the flow of patients through emergency departments to avoid exit block, the term used when patients cannot be moved into a hospital bed.

2.) The Society for Acute Medicine is the national representative body for the specialty of acute medicine. For more information, visit www.acutemedicine.org.uk or reply using this email address.

 

for Acute Medicine is the national representative body for the specialty of acute medicine. For more information, visit www.acutemedicine.org.uk or reply using this email address.

 

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Senior medic calls for “substance before soundbite” from the government

A senior medic has called for the government to put “substance before soundbite” when it comes to the realities of the effects of COVID-19 on the NHS.

Dr Nick Scriven, immediate past president of the Society for Acute Medicine, said despite regular references to creating “spare“ capacity, this was far from an accurate reflection and distracted from the “worrying” long-term picture.

“Only a week ago the health secretary stated confidently he has always ensured NHS capacity has met demand but that is quite frankly an absurd manipulation of the truth,” he said.

“This type of spin won’t wash as, to be clear, the so-called “capacity“ being described of late has only been made possible because hospitals have adapted to the pandemic and because seriously unwell people have not been seeking medical care.

“However, what the reality means is that thousands of planned procedures and appointments have been delayed, while those who have not sought urgent care will be attending hospitals in much worse conditions – so there are consequences.

“The utopia of an NHS that has bundles of spare capacity and can cope with anything is a fallacy and to use the pandemic as an opportunity to claim demand has always been met is frankly outrageous.”

Dr Scriven said there was growing concern about the pressures on hospitals and staff when non-COVID activity begins to return and COVID patients continue to be cared for by staff who were already stretched long before the pandemic.

“As the number of non-COVID patients slowly increases it will strain hospitals who will still need to maintain separate areas for COVID and non-COVID to ensure minimal chance of infection in hospitals and that also means stress on staffing levels which are already stretched.

”One of my main concerns is staff resilience. People have now been working outside their usual work patterns or outside their normal hours – often with highly disruptive working hours – for more than a month.

“If or when we get either the second wave of COVID and/or a surge in poorly people with other health needs who have so far tried to avoid coming to hospitals, staff will have little reserves unless we see far better staff wellbeing management from the top.”

Dr Scriven said that it was not appropriate or fair to “insult people’s intelligence” by making “misleading claims” about the ability of the NHS to manage demand.

“Ultimately, despite what rhetoric we hear from the Secretary of State or other ministers or attempts to divert public attention, the pandemic does not wipe out the history books.

“The issues that existed long before COVID – chronic underfunding, a crisis in social care, 40,000 nursing vacancies, 10,000 consultant vacancies – are all still present.

“What we need is to see is government facing up to the realities of this and delivering comprehensive plans of how it expects to see the NHS manage the return of planned care alongside ongoing COVID presentations combined with pre-existing dilemmas that they’ve still yet to resolve.”

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