NHS staff are some of the brightest, most selfless and heroic people on this planet. They work under unimaginable pressure to achieve miracles and are often paid very little for their efforts. It is absolutely right for the government to continue to increase funding and the workforce, especially as we live with an increasingly aging and diseased population.
But recruiting more frontline medical staff and increasing the NHS budget for day-to-day expenses will not alleviate the current crisis in emergency care or bring about a sudden turnaround in the growing waiting list. That’s because these crises aren’t caused by staff shortages, they’re caused by bed shortages.
If you put another fully equipped ambulance on the road, you will be able to take an additional person, but if you have not freed up an additional bed, the patient will have to join an even longer time. queue outside A&E.
Don’t just take my word for it. Compared to the eve of the pandemic, the NHS now spends 11 per cent more on daily activities in real terms. and despite record numbers of voluntary resignations, the NHS has 12 per cent more hospital doctors and ambulance staff and 8 per cent more nurses. Yet today it treats 12 percent fewer waiting-list patients than it did in 2019 and admits 14 percent fewer emergency patients. Virtually all measures of activity have declined (although new cancer citations are an encouraging exception).
These are the surprising findings of a study conducted by Max Warner and Ben Zaranko at the Institute for Fiscal Studies, which underscores the extent to which this crisis is a crisis of beds, and an infrastructure crisis in general, rather than a crisis of personnel and day-to-day resources.
By my calculations, the only indicator of NHS capacity that has been reduced over the same time period is the number of beds available for new non-Covid patients.
Nominally, there are almost exactly the same number of staffed beds in English hospitals today as there were in December 2019. But this is not true in any practical sense. Nearly three years into the pandemic, there are still around 2,000 hospital beds in use by severe covid patients who might not otherwise be there. And much more significant, there are almost 14,000 beds occupied by patients who no longer need to be in the hospital. More than double the additional capacity currently available to admit emergency patients is idle.
And why aren’t we seeing this near-collapse in one country after another? Because the British government has not invested enough in infrastructure for the better part of the last two decades. Total UK health spending is no different from other countries, but its capital investment is anemic. Going into the pandemic, Britain had fewer beds per capita than virtually any other developed country. One of the few countries to run a similar lean operation, Canada, has also suffered the ignominy of an ambulance crisis in the middle of summer.
Without the ability to conjure up thousands of beds out of thin air, solve the problem of late discharge, and reduce the amount of time people have to spend in hospital overall, is the only thing that will rescue the NHS from this permanent winter.
The instinct here is to blame solely the underfunding of social care, but there are far lower fruits. Record-keeping systems are so outdated that many English hospitals don’t know how many staffed intensive care beds they have, making planning for the efficient transfer of patients in and out of beds impossible, and the NHS already has case studies to point out. for digital transitions that accelerate patient flow.
I don’t expect us to applaud software platforms anytime soon, but as a country we do care about empowering our frontline doctors to do what they do best and alleviate the unbearable stress caused in large part by having to operate with outdated equipment infrastructure, then we need to move the conversation beyond “more cash and more doctors”.
