I had my usual regular catch-up meeting with Dr Hal Spencer, Chief Executive at the Chesterfield Royal Hospital NHS Foundation Trust, last Friday but despite the best efforts of the wonderful staff at the Royal, I remain deeply concerned about the pressures that the hospital and our NHS is under this autumn.
The pressure on the NHS means we are seeing numerous hospitals and trusts across the country declaring critical incidents, and this is before we are even into the winter with its usual impact on services. Our hospitals are reaching crisis point and the government need to take action now to save lives.
Dr Spencer told me about patients having to wait on trolleys in corridors for over 24 hours, something I was aware of as a staff member’s relative was one of these.
I also heard of patients having to wait over six hours to be seen by a doctor at A&E and of staff in the emergency department virtually in tears because of the pressure they are under and their concerns about patient welfare.
One of the biggest problems for the Hospital is the lack of social care capacity in the community, which then has a knock-on impact on other health and care services. Across the country, 1 in 7 hospital beds are occupied by patients who are medically fit to leave, but can’t be discharged because there is no social/ community care to support them. Dr Spencer told me that last week the Royal had 100 patients who could not be discharged as there was no care package in place to support them at home or there were no care home places available.
During Liz Truss’ campaign to become Prime Minister, she promised to put £13 billion into social care but this has been downgraded to a £500 million social care discharge fund. The Local Government Association (LGA) has said £6 billion is “needed immediately to increase care worker pay, meet demographic and inflationary pressures and stabilise the provider market”, so £500 million is far too little. A Labour Government would create a National Care Service and the first step will be strengthening the care workforce by ensuring full rights at work, decent standards, fair pay and proper training to care staff.
We also have a recruitment and retention problem in the NHS that is reducing capacity. There are over 130,000 vacancies – including 47,000 nursing vacancies and 10,500 doctors – within the NHS which has reduced bed spaces in hospitals as they simply do not have the staff to care for patients. Our nurses are over-stretched and underpaid, causing many to leave the NHS altogether – with stats from the Nursing Times showing that around 40,000 nurses left in the year to June 2022. It is simply absurd that an organisation the size of the NHS does not have a proper long term strategy for the workforce.
One other major concern, and something I have raised recently in Parliament, is the problem with handover delays for ambulances attending A&E departments. The Chesterfield Royal has a good reputation for the turnover of ambulances at A&E, but other hospitals in the East Midlands often have ambulances queueing for hours as their patients cannot be admitted and which only seems to be getting worse, as reported by the BBC last week – https://www.bbc.co.uk/news/uk-england-nottinghamshire-63138733
These delays at other hospitals in the region have a knock-on effect for Chesterfield as ambulances have to be diverted out of area to respond to emergencies. I have been informed that there was 15 ambulances waiting outside Derby City Hospital for over two hours last week – ambulances that should be back out there attending emergencies and saving lives. You can watch my question to the Health Secretary on this issue at https://www.tobyperkins.org.uk/2022/09/06/toby-perkins-question-to-the-health-secretary/
We all know how difficult it is to secure an appointment with a GP at the moment – another problem that needs urgent action from the government –and, whilst I appreciate how frustrating the long delays can be, it is important that people do not attend A&E for issues that are not an emergency as this is only causing added delays and pressures on the hospital.
This is a really worrying time for hospitals and it is only likely to get worse this winter. The Government need to take short-term emergency action to ensure hospitals can make it through the winter – but we need a long-term plan that ensures the hospitals have the the staff and facilities they need, and that patients who should be receiving care in the community are not blocking beds.