The National Health Service it is bracing for an influx of patients between now and Christmas after thousands of people postponed seeking treatment during ambulance workers’ strike on Wednesday.
Leading doctors warn that the decision by many people in England and Wales not to call for help as paramedics went on a 24-hour stoppage will leave the NHS struggling to cope at a time when hospitals would traditionally scale back their services for the festive break. .
The warning came amid signs that ministers, appalled that nurses and midwives in Scotland rejected a 7.5% pay increase, now believe there is no deal to make with healthcare unions and so they prepare for a battle of wills that will last all winter, punctuated by strikes.
Thousands of ambulance workers, paramedics and others in England and Wales went on strike on Wednesday, leaving the NHS unable to respond to many 999 calls. Eight of England’s 10 ambulance trusts declared “critical incidents” due to pressure about resources.
Hospital chiefs praised the public for heeding NHS advice to avoid risky activities if left defenseless and unable to reach A&E, and to call 999 only for life-threatening emergencies.
However, the leader of Britain’s A&E doctors expressed concern that the widespread suspension on Wednesday could worsen the health of patients, in the same way as people who did not contact the health service when the covid-19 caused damage and even death of patients.
Calls to 999 seeking an ambulance dropped by up to 25%, while emergency attendance was also much lower than usual, in a dramatic, but temporary, reduction in the usually intense stress on ambulance services. and hospitals.
“We are concerned that people are not seeking help when they should. We saw this during the lockdown,” said Dr Adrian Boyle, President of the Royal College of Emergency Medicine. “We are particularly concerned about a rebound effect, which means that things could be much worse in the coming days.”
Dr. Tim Cooksley, president of the Society for Acute Medicine, echoed that concern. “The festive period is going to be extremely tough,” he said, referring in particular to hospitals, which generally try to send as many patients home as possible for Christmas.
NHS bosses have told The Guardian that hospitals could end up much busier and more crowded than usual over Christmas, when there are usually only a limited number of staff on call, and patients stay in hospital for much of the period. festive.
“After the strike ends, we will have [ambulance] crews picking up people who have been on the ground for a long time, plus people who didn’t try to get in on Wednesday because they knew about the strike,” said the executive director of an acute care hospital.
“We think we will see more people coming on the Thursday and Friday, before the Christmas weekend, and with little hope that people will return home if they need support from social or community care. And then we’re at Christmas and New Years, when nothing moves much.”
Saffron Cordery, acting chief executive of NHS Providers, said hospitals were facing a backlog of operations and postponing clinic appointments due to the ambulance strike.
She said: “Leaders across the NHS also know that as this week’s strike draws to a close, the disruption is far from over. The fallout from the strike is likely to spill over into the coming days due to the knock-on impact on different parts of the health and care system, the need to reschedule elective and outpatient appointments, and the anticipation of a return to very high numbers. of emergency calls.
“There is particular concern about patients who may have delayed seeking care and whose conditions have deteriorated, and are now presenting for treatment.”
The NHS Confederation said senior executives were concerned that patients faced increased health risk and rapid access to treatment due to what appears to be a protracted fight between unions and government over the coming months.
Matthew Taylor, chief executive of the organisation, said: “The concern is that this is just the beginning and that the full impact of the current crisis [ambulance] The strike, along with the first two nursing strikes, will not only be felt today, but also in the days and weeks to come.
“Their fear is that the risk to patients will intensify, with future strikes planned and no sign of a resolution to the disputes.”
He blamed the escalating campaign of strikes across the NHS, and the resulting disruption of services, on the government’s £1,400 pay offer to staff and the refusal of ministers to engage in any negotiations that might increase that addition.
“In possibly the most tumultuous winter for health this country has faced, the government must come to terms with the unions. We cannot afford to let this turn into a prolonged winter of industrial action and disruptive warfare of attrition.”
That prospect seems to have come closer, with ministers toughening up their stance towards health unions after members of the Royal College of Nursing and the Royal College of Midwives, in Scotland. rejected what the Scottish government had said was their “best and final” wage offer of 7.5%.
“After that, the government is not going to blink. They think: ‘Well, if they turn down 7.5% in Scotland, they’ll turn down anything we offer them. [above the existing £1,400 offer]’ so there’s no point in increasing the offer, there’s no deal to be made,” said a source familiar with ministerial thinking.
However, Stephen Dorrell, who was health secretary under John Major, criticized the government’s refusal to increase its offer, which equates to a raise of around 4% for most staff, or to open talks about a possible increase.
Dorrell, who has since joined the Liberal Democrats, said: “The government has really played their cards very badly. The only thing they should have been trying to do is avoid taking on the entire public sector at once.
“There is a review body process for the health service. It would not have undermined it if ministers had simply asked the review body to review the NHS annual deal again, given the exceptional circumstances of having 11% inflation.
Health secretary Steve Barclay said: “These are difficult times but we have accepted the recommendations of the independent NHS pay review body in full, meaning most ambulance staff have received an increase of at least minus 4%. This will take the average earnings to around £47,000 per person. More wage increases would mean taking money away from frontline services at a time when we are facing record wait lists as a result of the pandemic.”
The telegraph reported on Wednesday night that Barclay is about to “speed up the process” of giving NHS staff a pay rise next year, in a bid to break a deadlock with the health unions.
A source close to Barclay said he acknowledged NHS staff were “feeling the pinch” and would demand action to see any extra money in pay packages “at the earliest opportunity”.
Earlier, Steve Brine, the Conservative MP and former health minister who now chairs the Commons health select committee, had backed Rishi Sunak’s refusal to review this year’s wage deal – the £1,400 figure that triggered the strikes.
Brine urged ministers to stand firm in not offering more money than is recommended by the wage review body. But he also suggested that next year’s pay review process could be sped up to give ambulance workers the promise of another pay rise to come.
“There is no way for ministers to trample on this process and there is no way for them to do that,” he said.
“But they can tell the wage review body that they want a shorter job based on the great report they did last year. That could report before next summer, and we’ll be in a better place by then. But in the meantime, the unions should stop the strikes.”