When you look around an accident and emergency department, everything is on display: people’s pain, fear, courage and hope; the unfailing dedication and expertise of the staff who work there; and yes—the challenges facing the NHS.
From hospitals across the country we’ve heard that this winter crisis is not a surface issue or a temporary one. The symptoms are all connected and multiply into new problems. You don’t see it in statistics alone. But you do see it in A&E departments. I am a doctor, and so have an idea of how stressful it must be for staff working day in, day out, as well as the patients they are caring for.
The departments are completely overcrowded. The reality is that people feel forced to come to A&E that shouldn’t have to be there: people who couldn’t get a GP appointment, people who had to wait too long for a hip replacement and are now in severe pain. Together with the emergency cases—from heart attacks to road traffic accidents—it is simply too much for the resources we are currently putting in.
The reality is stark: cubicles are full because there’s no space to move people onto wards. The wards are crammed because the social care system is completely inadequate in supporting people to return home. When no beds are available, you see ambulances queuing up outside hospitals. They are full of patients who can’t get the hospital care they need and paramedics who can’t do what they’re trained to: go to the next person who has called 999.
The reality is that doctors are too stretched to do the job we are trained to do: to treat the symptom and the cause—there’s little time for prevention.
On New Year’s Eve, I worked a shift in A&E. We had a teenage girl who fainted. We checked her over and made sure she was fine. What we pride ourselves on being able to do is really find out why she’d fainted—is there an underlying eating disorder? Is she being bullied at home or school? To have these conversations, you need to build trust and that takes time.
What does that mean? That the patient will likely have to return for more care at some point, further increasing the pressure on the already crumbling NHS.
It won’t change until this government decides to live up to its most sacred duty: the protection of the health and security of all of us. It’s time we saw a change in A&E and at the Department of Health. The NHS’s historic under-funding is not an economic necessity—it is a political choice.
The staff will carry on giving their all, of course. You don’t see their work in the headlines, but in some of the most harrowing, important, joyful moments of people’s lives.
