Commenting today (07 October) on growing levels of pressure across the NHS, Dr Tim Cooksley, president of the Society for Acute Medicine, said:
“We are deeply concerned that workforce and capacity issues in the NHS are simply not being addressed quickly or comprehensively enough to avoid disastrous consequences this winter.
“We have delays in emergency departments because patients cannot come to acute medical units (AMUs), we have patients unable to move forward from AMUs to downstream wards and patients cannot go home from the downstream wards because of challenges in social care.
“Pressures throughout each of these areas mean that patients are not moving through the system in a timely way and are not getting their care delivered effectively.
“This causes a slowing throughout the whole chain of care but it is unfortunately at no one single point – there is pressure everywhere.
“The pandemic really revealed the lack of capacity within the system and the lack of ability to deal with any excess challenge which Covid clearly presented.
“Patients who became unwell with other problems during the Covid pandemic have and continue to present with their other conditions later which often requires more complex management and they are more poorly – but the resources are not there to help support them with their new conditions effectively.
“Alongside that the Covid pandemic caused a lot of psychological impact and has caused significant reduction in morale among NHS staff, with extreme burnout in many of our colleagues who are no longer able to work full time or indeed able to now work at all.
“That has increased workforce challenges and colleagues failing to see when things are going to improve for both themselves and, more importantly, for the patients they are looking after.
“I said recently that referring to a “crisis” is always a challenging question because we have referred to the NHS being in crisis so frequently over the last few years that people almost become immune to that as a term.
“There is no doubt, however, that the NHS has been through a sustained period at very high risk when much more should have been done to mitigate the huge workforce and capacity challenges that we have and continue to face.
“The concern of my colleagues and I currently is that the theme that we have previously described about the situation being a crisis is, with hindsight, wrong. It was hugely challenging but now we are seeing a new definition of what crisis actually means.
“The potential of a bad flu season and further Covid waves combined with the risk of worsening health issues due to cost-of-living challenges, workforce and capacity issues in the NHS and a system still in paralysis is truly daunting.”
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.