NHS system becoming increasingly compromised – SAM president

Commenting on current and rising pressures in the NHS today (06 April), Dr Tim Cooksley, president of the Society for Acute Medicine, said: “Spring has yet to bring any relief to NHS and social care which continues to be under immense strain. This is reflected in current performance data and the statements from hospitals and regions outlining the pressures in acute care. 

“While collaboration and innovation by clinical and operational colleagues have ensured that emergency care is being delivered, the system is becoming increasingly compromised.

“Overcrowding in acute care settings results in worse patient outcomes and this is exacerbated by high staff absence levels due to the current levels of COVID-19. 

“Throughout NHS and social care, workforce challenges intensified and exacerbated by this situation mean that patient flow throughout the system is impaired and patients are stuck for long periods in emergency departments and acute medical units (AMUs).

“Paramedics are then stuck unable to transfer their patients into hospitals and get back on the road, resulting in 999 patients at home left for longer periods without clinical assessment and treatment. This potentially has a significant impact on their outcomes.

“Acute care teams continue to strive to provide high quality care but fatigued staff with the current workload demands struggle to achieve this and that has a significant impact on morale. While teams continue to work tirelessly to ensure they provide timely care for unwell patients, the ability to do so is being increasingly challenged.

“The new NHS England discharge taskforce will hopefully help impact change but will be dependent on significant further investment in social care to achieve its aims. 

“Workforce and capacity remain the two main aspects of recovery to ensure that safe, sustainable and world class acute care can be delivered. It is imperative that, politically, urgent and emergency care recovery is given the same importance as elective – non-urgent – recovery.”

Dr Nick Scriven, past president of the Society for Acute Medicine, added: “Pressure is immense across the whole system but is really being focused at the “sharp end” with hospitals trying to cope by expanding acute medical unit capacity if there is any physical space.

“Staff are at risk of physical and mental exhaustion and, while there is no quick and easy fix, we need to prioritise staffing these areas to safe levels across the teams to support assessments and treatment. 

“To make a lasting difference we need a system reset across the whole community, primary, secondary and social care system as there is currently a massive disconnect that is serving only to cause the problems we now see.

“The COVID pandemic is still very much severely impacting on the NHS and we need the public to realise quite how bad it is in the face of sparse public messaging. It is vital people continue to try to minimise the spread of the virus.”

SAM would support much more central political messaging more generally in terms of approaches to health and social care, patient expectations, challenges of recovery and how that is being impacted COVID and exacerbated by current high levels of infection.