The reason for the growing inability of A&E units to cope is down to this goverment’s policies: slashed local authority budgets mean social care cuts are trapping elderly people in hospital beds as they can’t be discharged safely; widespread hospital and A&E closures and loss of beds are increasing pressure on surrounding areas and meaning A&E patients can’t be admitted; and insufficient doctors and nurses are in place to deal with A&E patients.
The King's Fund quarterly report has highlighted the very serious problem of delayed discharges : "during the past year there has been a 50 per cent increase in waits for care packages, a 42 per cent increase attributable to waits for nursing home places and a 22 per cent increase in waits for assessments."
NHS111 has also been contributing to the pressure. Since it was privatised, it’s been run by non-medical staff, cheaper to employ, but who are just following instructions and unable to make clinical judgements and will always err on the side of caution and recommend a visit to A&E.
What is needed is proper long term planning and investment at all levels of the health service from GP to hospital to community care. That means increasing training places , reversing the cuts to general practice, hospitals and social care budgets and ensuring that funding rises to keep up with growing population needs.
We are calling for a raft of measures that would help ease the current crisis:
1. Halt all planned closures of A+Es and acute hospital beds; make more hospital beds available by taking the “moth-balled” ones back into use.
2. Launch a recruitment drive for more staff and reverse the real terms cuts to NHS staff pay to draw people, who have left or recently retired back into work, on a temporary or permanent basis.
3. Increase ambulance availability – reverse the cuts to the ambulance services and halt the drain of skilled staff out of the service.
4. Put a cash injection into council budgets to fund social care adequately.
5. Make the NHS111 helpline clinician-led by re-employing experienced NHS Direct nurses.
6. Halt the closure of NHS walk-in centres and increase public awareness of the alternatives to A&E.
7. Invest in GP services and reverse the cuts to the GP out of hours services.