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Struggling hospitals facing 'huge tragedy' Crowded hospitals ‘put patients at risk’
(about 1 hour later)
Patients are at risk in overcrowded hospitals as the NHS struggles to cope with the deluge of patients seen in recent weeks, a senior doctor has said. Patients are at risk in overcrowded hospitals as the NHS struggles to cope with the surge of patients seen in recent weeks, a senior doctor has said.
Prof Suzanne Mason, from the Royal College of Emergency Medicine, described it as a "huge tragedy".Prof Suzanne Mason, from the Royal College of Emergency Medicine, described it as a "huge tragedy".
Reports have emerged of patients facing long waits for treatment and being stuck on trolleys in corridors and of ambulances left queuing outside A&E.Reports have emerged of patients facing long waits for treatment and being stuck on trolleys in corridors and of ambulances left queuing outside A&E.
NHS bosses have responded by cancelling non-urgent care en masse. NHS bosses said plans were in place to deal with the pressures in England.
Tens of thousands of operations, treatments and appointments have been put off for the rest of January as hospitals have tried to ease some of the pressure. This includes the cancelling of non-urgent treatments, such as hip and knee replacements, until the end of January.
But Prof Mason said the move was "too little too late" as hospitals simply had no beds free and these treatments would have had to be cancelled anyway. Hospitals have also been given the green light to put patients in mixed sex wards.
NHS England director for acute care, Prof Keith Willett, said he had not seen such pressures in the NHS since the 1990s, but he denied the service was in crisis.
"A crisis is when you haven't got in place mitigations and you haven't got a plan to deal with it," he said.
"We've gone into this winter in a way we've never prepared before."
Doctor warns of 'huge tragedy'
But Prof Mason said the measures were "too little too late" as hospitals simply had no beds free and these treatments would have had to be cancelled anyway.
She added: "Patient safety is being compromised - there's no doubt about that. When patients are in crowded emergency departments and staff cannot actually move between patients and provide the basic level of care that's required, then safety is compromised.She added: "Patient safety is being compromised - there's no doubt about that. When patients are in crowded emergency departments and staff cannot actually move between patients and provide the basic level of care that's required, then safety is compromised.
"Patients who spend many hours on a trolley - and these are often elderly patients - they are the sickest patients in our department."Patients who spend many hours on a trolley - and these are often elderly patients - they are the sickest patients in our department.
"They are much more likely to have a poorer outcome and even die as a result of their experience in the emergency department. And that is a huge tragedy for us in our specialty and that's why we are so desperate to see things improve.""They are much more likely to have a poorer outcome and even die as a result of their experience in the emergency department. And that is a huge tragedy for us in our specialty and that's why we are so desperate to see things improve."
NHS England's director for acute care, Prof Keith Willett, told BBC Radio 4's Today programme he had not seen such pressures in the NHS since the 1990s. Reports have emerged of serious problems in a number of places:
But he denied the service was in crisis. How has the NHS responded?
"Well a crisis is when you haven't got in place mitigations and you haven't got a plan to deal with it," he said. As well as cancelling non-urgent care in advance - in previous years it has tended to be done at the last minute - a range of other steps has also been taken, including bringing GPs into A&E units to treat less serious cases.
"We've gone into this winter in a way we've never prepared before. The NHS response is also being co-ordinated centrally by a new National Emergency Pressures Panel composed of senior doctors and managers.
"We went into the winter before Christmas having cancelled fewer elective operations than previously, our discharges were at a lower level than previously so we were better prepared." It was this panel that ordered the cancellation of some non-urgent cases, although treatments for cancer are being prioritised.
NHS England's National Emergency Pressures Panel, which met on Tuesday, said it had extended the deadline for deferral of all non-urgent inpatient elective care - such as hip or knee replacements - to 31 January, to free up capacity for the sickest of patients. Why has this happened now?
NHS England also gave hospitals the green light to put patients in mixed sex wards. The first week of the year is always difficult.
The lack of availability of community services, such as GPs, over the festive period means hospitals tend to see a surge in really sick patients at the turn of the year.
Respiratory illnesses also tend to spike after families have been mixing over Christmas bringing frailer older relatives in contact with young family members, increasing the risk of infections being passed on.
But it is also true to say that this is part of a pattern.
Last January was the worst in a generation and that followed the previous worst the year before.
Commentators have blamed this trend on the squeeze on NHS finances - the health service is in the middle of its toughest cash settlement since it was created.
Since 2010 annual rises have been limited to about 1% on average each year, compared to more than 4% it received previously.
How bad is the situation?
It is very hard to tell. The performance stats - covering waits in A&E, the number of ambulances queuing outside A&E and the amount of operations that have been cancelled - will not be known for a few weeks.
In the lead-up to Christmas, all the indications were that the NHS was in as bad a position as it was the previous winter.
Twice as many patients were waiting for more than four hours in A&E as they should have been, while bed occupancy rates were well above safe levels.
But last winter the really bad spell only lasted a couple of weeks before the pressure eased.
Therefore, it will only be later in January that it will be known whether the NHS is facing a sustained problem.
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