I don’t know about you, but during the recent freezing weather, I was much more careful than usual when moving. I didn’t need a disembodied voice in a train station to tell me that the platform might be slippery when wet, or to be advised to wear grippy shoes in the snow after the excesses of a Christmas party.
I was well aware of the fact that if I fell and broke my leg or hip, I would most likely be trapped, motionless, for hours because the chances of an ambulance showing up in a reasonable time they were close to zero. If she was out in the cold, she’d probably succumb to hypothermia before seeing a blue light. And even when he was rescued and taken to the hospital, chances are, depending on where he lives, he would spend hours stuck in the vehicle outside of A&E.
A broken leg, however agonizing, is not considered an emergency that requires immediate ambulance assistance, but neither, you may be alarmed to learn, is it a heart attack or stroke. These are known as Category 2 cases. The highest category is for “time critical, life threatening” incidents.
But chest pains, which may or may not be a heart attack or stroke, are considered less serious. However, they were worrying enough that the NHS in 2018 recorded an average response time of 18 minutes for an ambulance to arrive.
Now it’s 41 minutes. In some areas, by definition, it is much higher, over an hour in fact. If you’ve had a stroke or your chest pains turn out to be the precursor of cardiac arrest, such a delay could be terminal.
For a broken bone, by the way, a two and a half hour wait is probably the best you can hope for. It was recently reported how Melvyn Ryan, an 89-year-old Army veteran who broke his hip in a fall at his home, was tied to a plank of wood and transported to the hospital in the back of a pickup truck because there were no ambulances. available. The NHS apologized, saying his experience fell below the standard he claimed to offer. you do not say
This is the grim background to the ambulance workers’ strike. Government warns of risk to patients of unions ordering a job to rule, banning overtime or failing to answer non-emergency calls as they once did during a six-month dispute in 1989/90, when it intervened the army. as you have been asked to do again. The big difference now is that even when the ambulance service is running normally, we are at risk because it is already at its limit.
The big question is why, and this was raised by parliamentarians at the Commons Health Select Committee yesterday to a panel of NHS and union representatives. The consensus was that the main cause was the inability of hospitals to discharge patients who should no longer be there. One in seven beds is occupied by people deemed fit to leave or unable to receive treatment, but who have nowhere to go or will not be discharged until a ‘care package’ has been put in place.
The knock-on impact of this is obvious. Ambulances get stuck on the esplanades; the paramedics on board attempt to treat them but are not trained in what are then essentially nursing duties over long periods; And those ambulances aren’t available when you or I collapse in the street.
On December 11 in England, ambulances spent 4,232 hours waiting outside hospitals, which is equivalent to 176 vehicles. not available for emergency responses. There has been a 50 percent increase in Category One calls in the last five years, and yet ambulance crews are seeing fewer people than before. We have a sicker and older population calling ambulances much more regularly than before, and yet the turnover is lower.
This is failure at its most basic level. When sick and injured people can’t even rely on an ambulance to arrive in a reasonable amount of time, let alone as quickly as befits an emergency, then the system is broken and there’s no point in continuing to pretend that there will be adjustment here and change. of process there. make any difference.
Other deficiencies are contributing to a record number of excess deaths, including late cancer diagnoses and operations canceled during the pandemic when the government actively discouraged people from using the health service. What was supposed to be a strategy to “save the NHS” ended up destroying it and this will be exacerbated by the various strikes.
Who is really in charge of this chaos? It is widely, albeit wrongly, assumed that the Health Secretary runs the NHS but has little power, such as Steve Barclay is the last to know. NHS England has a management structure with the invisible amanda pritchard at his apex as CEO. Does he have any influence, and if so, what is he doing? Or you have to look at the presidents and boards of directors of the hospital boards, since that is where the biggest problem lies, the so-called “delivery” of patients with no place to go.
At the select committee hearing, NHS England sent Professor Julian Redhead, national clinical director for urgent and emergency care, who said everything possible was being done to secure 7,000 “new or virtual” beds, though how virtual beds will help whether he can’t discharge the patient to begin with is unclear. Isn’t it possible to transfer patients who no longer need treatment to some kind of nightingale hospital the kind that was built but never used during the pandemic?
All health services are under pressure from demographic change, an aging population and increased demand, but none seems to be as bad as ours. Thirty years ago this could have been attributed to funding, as the NHS received less per capita than equivalent health services. But this is no longer the case.
Germany and the UK now spend about the same per capita on health, but the former has better results, many more beds, and is not constantly on the brink of collapse. Why? Professor Redhead said it was important to learn from best practice abroad. But the biggest difference is that overseas health services are not nationalized giants resistant to change. Until politicians are prepared to be honest about the true causes of this unfolding disaster, don’t fall and have a heart attack this Christmas.