Commenting on the upcoming Spending Review for The i Paper (10 June), Dr Tim Cooksley, immediate past president of the Society for Acute Medicine, said: “Urgent and emergency care remains in a state of crisis: a microcosm of NHS and social care which is struggling in all areas and completely collapsed in others. Therefore, when someone asks “what do you want from the upcoming spending review?” the immediate response is relatively simple: investment in staffing and capacity so that we can deliver an acceptable standard of care to patients.
“The grim reality is well known to everyone who works in acute care and increasingly personally experienced by large numbers of people by either their own patient journey or that of a loved one. Degrading corridor care, poor patient experiences, significant delays, low staff morale and indisputably patient harm and death is occurring daily in every hospital in the country.
“This is an appalling situation. Further, the crisis has not yet nadired and current trends suggest the upcoming winter will be worse still, as unimaginable as that largely is.
“Thus, this should and must be a priority in the spending review. Primarily there needs to be a recognition of the situation and not faux descriptions of improvements and a brighter future that simply are not supported by expert frontline colleagues.
“At the heart of the crisis remains the challenges in social care. No hospital recovery will occur without sustained and significant improvements in the availability of social care. This requires a people recovery driven strategy to deliver personalised care to people in their own homes. Waiting for the Casey review, as insightful as undoubtedly that will be, is unacceptable: particularly when previous comprehensive and respected reviews have outlined the key components and requirements. That social care package and investment needs to be described in the spending review; the work needs to be funded now and a failure to do so is a continued dereliction of basic Government duty.
“Hospital services require a staffing and capacity plan that spans at least a decade matched to predictable population needs. Ideally, this needs to be independent from the increasing instability of political manoeuvring.
“Of course, there are further inefficiencies to be made in the delivery of healthcare. That is also indisputable but often overplayed. Overcrowded hospitals and social care systems are deeply inefficient and cost burdens.
“The journey of NHS and social care recovery will be long and complicated with much sadness for many people along the way: as loved ones suffer unnecessary harm. This needs to be expressed as openly and truthfully as any other health care policy. It will take years to return to an acceptable standard of care in urgent and emergency care. The longer we take in starting that journey; the worse it will get. It hasn’t started yet; hopefully the spending review will be the desperately needed catalyst.”