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Leading medical body calls for politicians to address “elephant in the room” following worst performance on record

A leading medical body has called on politicians to address the “elephant in the room” during campaigning before any further “puff” announcements on the NHS are made after the worst A&E performance figures on record were released today.

The Society for Acute Medicine has warned acute and emergency care in the NHS is “imploding” – before the expected winter crisis hits – and there are as yet no credible plans from any parties to deal with it.

Data for October showed only 83.6% of people attending our emergency departments were seen within four hours and, for the sickest patients, this fell to 74.5%.

This is in the context of ever-increasing demand, with a 4.4% rise compared to October 2018 in attendances and a 4.6% rise in admissions over the last 12 months.

“These figures are truly worrying as we haven’t even reached the “traditional” winter period yet,” said Dr Nick Scriven, immediate past president of SAM.

“Urgent action is needed across the health service now to look at the capacity to meet this challenge.”
He said hospitals were under “intense pressure” with many at full capacity, yet politicians were “avoiding the elephant in the room”.

“We have heard so many “announcements” over the last few weeks of half-baked projects that require either thrice promised money or are totally uncosted for the real world.

“With what we have seen with the critical incident over A&E pressure in Nottingham last week – and that is just the tip of the iceberg – this, to me, is simply the reality of the constant warnings made by experts now coming to fruition.

“Yet we are hearing parties talk about how they will be the saviours of the NHS by all manner of ways but the biggest crisis is facing us right now in acute and emergency care as we head into winter.

“We want to know, before any further NHS soundbites and puff about matters that will barely scratch the surface, what every party intends to do immediately after 12 December to prevent the service going into meltdown before Christmas.”

Dr Scriven highlighted the the four-hour emergency access target has not been met since 2015 – the year before the EU referendum took place.

“It is quite ironic to see the NHS being made the focal point of early campaigning, particularly by Boris Johnson and the Conservatives, given that the crisis in emergency care goes back even further than the Brexit debacle.

“When you look at some of the major issues of the moment – Brexit, climate change and healthcare – it is fair game for anyone to ask just what has been going on behind the scenes these last few years.

“The issue for all political parties in this election campaign is engaging the country when I, for one, believe nothing a politician promises in election periods – and there are plenty of those being made.”

He said questions need to be asked as to how, with the spectre of a more severe influenza season, there has been little action to address the growing recruitment issues while a pensions tax crisis has developed which poses an “extreme threat” to staffing this winter.

“There has been is no increase in beds available across the NHS and no reversal of the decline in numbers over the last decades.

“Last winter had no extraneous factors with relatively little flu and no real prolonged severe weather.

“This year we have the prospect of both of these, with the increased norovirus that will bring, alongside thousands of vacancies and senior clinical and non-clinical staff reducing hours due to a ridiculous taxation policy which remains unresolved.”

He added: “Parties really need to start looking at and talking about the hear and now to address the elephant in the room, rather than filling people’s minds with distraction tactics of policies which, if Brexit is anything to go by, will take years – if ever – to be implemented, let along have any impact.

“We have tried to engage repeatedly with the government over the last two years without meaningful reply and have written to the three main parties urging them to address these points without response.

“Frankly we expect better from all those running or hoping to run the NHS and so do patients.”

Dr Susan Crossland, president of SAM, said alongside financial issues and the pensions crisis, there was an “urgent need” to provide psychological support for staff ahead of winter.

“We want to reiterate that, as well as the other urgent problems of finances and the pensions fiasco, support is required for staff from a psychological perspective if we are to stop the NHS grinding to a halt this winter.

“We have tried to engage with parties but they are more intent on cheap point-scoring off each other and PR stunts than listening to the people on the ground and that simply cannot continue throughout this campaign.”

Acute medicine, also known as acute internal 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 plays a vital role in maintaining the flow of patients through emergency departments to avoid exit block, the term used when patients cannot be moved into a hospital bed.

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