A survey of members by the Royal College of Physicians paints a bleak picture of the state of acute care with increasing patient numbers and stretched resources. One in 10 would not recommend treatment at their hospital to family or friends.
Part of the problem is that we are living longer. Older patients account for two thirds of acute hospital admissions and with an aging population there are more of them. Another problem is fragmented care, with too little Consultant input and too little input from other Specialists. As the President of the Society for Acute Medicine says, ‘There is increasing evidence that a Consultant-led, multi-professional acute medicine team provides better outcomes for patients’.
A symptom of the crisis is a 10% increase in patient deaths at weekends when only junior staff are on duty.
In many of my recent most serious cases poor weekend care has played a major role in causing death or disability. In 3 cases nurses watched whilst patients went into Septic Shock over the weekend. None were reviewed by Doctors and Nursing staff failed to realise the significance of worsening observation results or to follow their MEWS protocols (systems for picking up early warning signs of developing Sepsis). In one case a woman in her early 60s who was recovering from Gallbladder surgery (Cholecystectomy) died. In another a 39 year old man had to undergo an above-knee Amputation. In a third a 40 year old man went into Atrial Fibrillation, developed a Thrombus (Blood Clot) on the Heart and then had a Catastrophic Stroke. He now needs 24 hour care. In all these cases people suffered avoidable Medical accidents because of negligent care and that negligence is probably explained in part by poor staffing levels at the weekend.
My own cases suggest that weekend hospital care is a significant problem and the survey seems to confirm this. The picture is bleak and the new Health Minister needs to pay attention to what the Royal College is telling him.
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