Country in grip of one crisis and heading into another – SAM past president

As pressures on the NHS continue to rise heading into the festive break, Dr Nick Scriven, immediate past president of the Society for Acute Medicine, discussed his concerns:

“Speaking in terms of the picture in north of England, the numbers of patients with Covid are starting to fall but we are seeing a rise to ‘normal winter’ levels of other presentations exacerbated by people who have deconditioned over the pandemic becoming unwell.

“We have found that in-hospital length of stay has for some doubled over the last six to nine months and the major stress is occurring due to a lack of flow though hospital wards and back to the community. Of course, the areas that really get to see the strain, apart from the patients themselves, are the acute medical units, emergency departments and ambulance crews.

“I suspect many many trusts have cancelled activity of some sort, whether it be routine clinics or procedures, to try to free up staff to help out but much of this will be ‘under the radar’ and maybe not seen in statistics yet. 

“Although health secretary Matt Hancock said yesterday that hospitals are less full than this week last year, I suspect he does not understand the reality of juggling bed spaces in the Covid era to keep patients safe and minimise nosocomial (in-hospital) spread.

“The lack of a clear plan from the government or the following of advice given by those on the frontline for the coming festive season is disturbing, as is the totally mixed messaging at the time politicians seem to want to take a chance on everyone ‘doing the right thing’.

“The four-day weekend followed a few days later by a three-day break will see hospitals fill up as they do every year, but now with the added inertia caused by the limitations we all work under along with exhausted staff who are being asked to go yet another extra mile having been stretched to breaking point already.

“We have talked for many years about an ‘eternal winter’ in the NHS and the challenges that alone brings all year round, but the actual winter is now on our doorstep amid a pandemic of the nature of Covid and no-one can say with certainty just how destructive that could be.

“What we do know is that the country is in the grip of one crisis and is about to embark on another in the coming weeks and the fact we will see a festive period with families mixing strikes fear into the hearts of clinicians on the frontline.

“We would urge people to see past the noise and the myriad of confusion and take whatever precautions they can to protect themselves, their family members and others while we work our way through this difficult period.

“Undoubtedly we will see a reduction in elective activity in the new year so any efforts to minimise the impact on healthcare services now will go some way in easing that burden in the coming months.”