Top doctor calls on government to announce NHS contingency plans ahead of ‘worst January’

A leading doctor has called on the government to announce its contingency plans ahead of “potentially the worst January” the NHS has faced.

Dr Mark Holland, president of the Society for Acute Medicine (SAM), said hospitals had already seen large numbers of elderly patients over the festive period and a spell of cold weather along with a rise in respiratory admissions could provide “the ultimate tipping point”.

“On 3 January the NHS in England will return to work at full capacity after the Christmas and New Year break and we do not know what we will face come Tuesday morning,” he said.

“Anecdotally, people who’ve been working over the holiday period feel that it has been very busy. We are already seeing lots of older patients in particular.”

He said SAM had previously highlighted the fact January is always a difficult month in the NHS after a drop in elective work over the festive period, but warned this year “has the potential for being one of the worst we have faced”.

“Record numbers of patients who are fit for discharge but with no social care in place provide a challenge at any time of year but, at the moment, there are too many unknowns to tell us if we will be able to get through January and avert a major crisis,” Dr Holland explained.

“With hospitals at full capacity and minimal, knee-jerk effort from the government to deal with the social care crisis behind it, a prolonged cold spell, norovirus and an outbreak of flu might provide the ultimate tipping point for us all.

“We at SAM have consistently highlighted our concerns regarding winter pressures which are now worse than ever and, today, we call on the government to tell us what the contingency plans are for a possible worst case scenario.”

SAM is the national representative body for the specialty of acute medicine, which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present to hospital as emergencies.

Dr Holland said that, despite requesting NHS England went beyond the four-hour emergency access target more than a year ago, there had been no acknowledgement or keenness to provide more clarity.

“We have highlighted that behind the four-hour emergency access target in A&E departments are hospital wards stretched to the limit – but there is little in place to take the appropriate action to remedy this,” he said.

“We believe – and have called for this for more than a year – that measures should be in place to report the overall function of our hospitals. For example, if patients are placed inappropriately on non-specialist wards, how often hospitals are full – known as black alert – and capacity-related major incidents.”

He added: “If this happened, we may be in a better position to understand all the factors affecting hospitals and take better, more efficient action to tackle the problems that are causing services to spiral out of control.”

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