It is clear that there is a crisis facing NHS hospital Emergency Departments. Recently the Health Secretary spoke of collapse and said that he would take a fundamental look at the problem. More evidence is emerging of the scale of the problem, with one third of hospitals failing meet the 4 hour waiting target and some simply giving up because it is unrealistic.
So what lies at the heart of the crisis? It is clear that there has been an increase in demand for services with a 17% increase over the past year. This may reflect increasing expectations of what the health service can do for us. However it may also be the result of changes elsewhere.
The Health Secretary is currently targeting GPs for failing to provide better out of hours care. One change is certainly the move away from GPs providing care out of hours and delegating it to others including private contractors who provide ‘Out of Hours’ services. There are signs that people simply do not have confidence in these services and prefer to go to Accident & Emergency, which they still trust. Other changes include is cuts in social services funding as well as pressures on NHS funding.
Speaking to MPs the president of the College of Emergency Medicine, Mike Clancy, described Emergency Departments as the ‘mat on which everything which doesn’t work falls’. He also pointed out the overcrowding in Accident & Emergency brings substantial risks for patients. We know that the more pressure on the service, the more likely there are to be mistakes. Given that this is the first port of call for many people with serious conditions it is important the staff have time to give the right care.
Things going wrong – fractures being missed, investigations not being done, referrals not being made – can give rise to serious harm. Many of our most serious cases come from negligent mistakes in Emergency Departments and these include people who suffer unnecessarily from Amputations, strokes, Brain Injuries and Cancer left to a late stage before it is diagnosed (misdiagnosis of cancer).
The Health Secretary was right when he said this problem needs a fundamental look. It will not be enough just to find a scapegoat and blame GPs. The government has embarked on a complete restructuring of the health service in the face of opposition from many hospital staff as well as imposing tight funding constraints and it needs properly to address what is turning into a crisis for patients.
By Clinical Negligence Solicitor Paul Sankey.