Emergency care will never improve unless the government and the National Health Service focus on bringing down the “terribly high” rate of hospital bed occupancy, the president of the Royal College of Emergency Medicine (RCEM) has warned.
Dr Adrian Boyle told Health and Welfare committee members that the additional investment announced by the government in recent weeks to help deal with the winter crisis is welcome but not a long-term solution.
Dr. Boyle said: “We definitely had the worst December we’ve ever had. Looking at the performance numbers, what happened in December was terrible in every way. This is a complex issue with many facets. I think we should be a little realistic about this. [extra] Money cannot be a magic solution. This is not a magic wand. We have serious structural problems that prevent us from providing emergency care.
“We have the second largest number of beds in the OECD. [Organisation for Economic Co-operation and Development]. Our hospitals are too crowded and too busy. They are awfully tall. [The investment] this is a step in the right direction, but recovery will take a long time. It went wrong for quite some time and came to a head in December.”
Compared to other countries, the UK has a very low total number of hospital beds in relation to the population. The average number of beds per 1,000 people in the OECD EU is five, while in the UK it is only 2.4. In Germany, on the other hand, 7.8.
While the total number of beds has decreased, occupancy has increased. Since 2010, average bed occupancy has consistently hovered above 85 percent, a level considered to be the point above which safety and efficiency are compromised.
Figures released by NHS England last week show more than 19 out of 20 beds in adult general and emergency departments (95.7%) were occupied in the week to January 15th. More than 14,000 beds have been occupied by eligible but ineligible people – so-called “bed blockers” – due to a lack of medical care in the community.
NHS England data shows a record 54,532 people who waited more than 12 hours in the emergency room last month after admitting they were indeed hospitalized. But Dr. Boyle said some of these patients may have waited hours before a decision was made to admit them to the hospital.
The figures also show that the number of patients treated within four hours in the emergency department in England fell to a record low of 65% in December. Dr. Boyle called for improved 911 service to eliminate unnecessary trips to the emergency room and urged hospitals to share the burden of the influx of patients rather than leaving crowds in emergency rooms for hours.
Dr Boyle also said NHS England’s new goal of admitting 76 percent of accident and emergency patients within four hours by the end of 2023-24 is “not ambitious” and would create “all sorts of perverse incentives”.
He said the new goal would encourage managers and senior medical professionals to focus only on people who can be discharged from the hospital, without addressing the key “curfew” problem that occurs when patients enter the emergency room (ED) who require hospital care. not have access to suitable hospital beds within a reasonable amount of time.
NHS England announced a new target of 76% last month after falling short of the old target of 95% since 2014. The target is the first time in several years that NHS England has set a specific target for a four-hour target.
Committee chairman Steve Russell called in Dr. Boyle to “show off his training” after claiming on New Year’s Eve that delays in emergency care had resulted in 300 to 500 extra deaths a week. The RCEM Chairman referred to a study published in Journal of Emergency Medicine studied the NHS England data set of seven million people last year.
Dr. Boyle said: “They showed that it takes five hours when you get there. [waiting], you begin to see an increase in the risk of subsequent 30-day mortality. And it increases linearly from about 5 hours to 12 hours. They stopped at 12 o’clock in the afternoon, because at that time few people waited 12 hours.
After statistically adjusting for factors such as age and multiple health conditions, the results showed that for every 72 people who stay more than 8-12 hours in the hospital, there is one additional death. Those who stayed 6-8 hours had one additional death per 82 people, indicating a gradual linear increase.
“[We got to the 300-500 excess deaths figure] if you apply that number from one in 72 to the number of people who have spent more than 12 hours in our emergency rooms,” the doctor said. Boyle.
He also told MPs that the National Health Service was “wearing out” older nurses by comparing them to non-commissioned officers (non-commissioned officers) in the military.
Asked how employees are handling the current situation, D. Boyle: “Even before this winter, we were worried about employee retention and morale. Last year, GMC conducted a survey of interns and reported that emergency care interns had the highest self-reported burnout rate and was worse than the previous year. I’m afraid the burnout will cause them to burn out.
“I also see nurses, especially older nurses – they are like non-commissioned officers, sergeants, they know how to get things done – leave en masse. Every time I go to work, I am asked to sign the nurses’ care cards. We pour blood on seasoned emergency room nurses who are unable to do the job they were trained to do.
“They get very frustrated with this level of inpatient care, they feel overwhelmed, they feel like their registry is at risk because it’s so dangerous. They are going through a very difficult time and that worries us a lot.”
Dr. Boyle called for improved 911 service to eliminate unnecessary trips to the emergency room and urged hospitals to share the burden of the influx of patients rather than leaving crowds in emergency rooms for hours.
NHS England Chief Strategy Officer Chris Hopson responded to criticism of winterization plans by telling the committee: “It is worth noting that without 7,000 additional beds or bed equivalents – virtual wards; not counting the additional 1000 call handlers 111 and 999; the community comes to the service; respiratory centers; and the system control centers we added this winter would greatly increase that pressure.
He added: “We prepared for this winter, we prepared for it earlier than before. The issue that always came up this winter was the extent to which we saw the prevalence of Covid and influenza and how well they matched.
Source: I News
I’m Raymond Molina, a professional writer and journalist with over 5 years of experience in the media industry. I currently work for 24 News Reporters, where I write for the health section of their news website. In my role, I am responsible for researching and writing stories on current health trends and issues. My articles are often seen as thought-provoking pieces that provide valuable insight into the state of society’s wellbeing.