Britain’s National Health Service is gripped by what doctors are warning is the worst crisis in a generation, as a worse-than-normal flu season piles pressure on hospitals still recovering from the Covid-19 pandemic.
Prime Minister Rishi Sunak’s government has been urged to respond to the “intolerable” situation, which doctors have warned stems from a chronic lack of beds.
Labour leader Sir Keir Starmer has accused the Conservatives of “12 years of mismanagement” of the health service, and said the Prime Minister was “hibernating” while nurses and ambulance workers were on strike.
The Liberal Democrats have called for Parliament, which is in recess until January 9, to be recalled early to address the mess.
Launched in 1948 by Clement Attlee’s post-war government, the NHS has for decades been the envy of millions of people in countries around the world. It is renowned as one of the first and most robust healthcare systems to provide free and universal care to those in need.
The main sticking points preventing the health service from thriving in 21st century Britain boil down to five issues.
Short on beds
Hospitals up and down the UK are constantly struggling to find enough beds for the number of patients coming through their doors. Doctors argue the shortage is creating a bottleneck which results in a lack of “flow” of patients through hospitals. The NHS has 2.4 beds per 1,000 people in the UK – half the European average of 5 per 1,000. Germany, where health care is of a particularly high quality, boasts 7 beds per 1,000 people.
Prof Rob Galloway, an A&E consultant at the Brighton and Sussex University NHS trust, said patients who no longer require urgent hospital care should be sent on their way.
“The first thing we need to do is open up capacity, and free up all NHS beds for those who need medical care,” he wrote in the Daily Mail. “The easiest way to do this is to discharge the medically fit patients to care facilities. We currently lack these facilities, but we could use private hospitals’ capacity, or even hotels.”
London ambulance executives have set a 45 minute deadline for hospitals to admit patients. NHS figures show that 37 per cent of handovers in the week to Christmas Day were delayed by at least 30 minutes, much higher than the 13 per cent recorded at that point in 2021 and 11 per cent in 2020.
Lack of staff
Patients who are well enough to be discharged are being kept in hospital wards longer than necessary simply because there is no safe place for them to go, medical experts say.
Richard Webber, a paramedic and spokesman for the College of Paramedics, said a lack of workers in care homes means they simply cannot accept patients who are fit to leave hospital.
“I talked to colleagues who work in acute hospitals and they are full of patients who should be elsewhere, they should be discharged out to care homes or need support in the community,” he told BBC Radio 4’s Today programme. “There is a lack of staff working in social care and a lack of capacity in social care, many hospitals have 100 or 200 patients who shouldn’t be in the hospital.
“They should be elsewhere being looked after in social care, they can’t be discharged, which means that the patients in the emergency department can’t be admitted to hospital.”
The NHS has in recent months been rocked by historic strikes as staff in multiple sectors call for an increase in pay.
Members of the Royal College of Nursing (RCN) in December took part in the largest walkout in its history to demand salary increases and better working conditions. Campaigners have argued that nurses are being forced to use foodbanks to survive and deserve a pay rise amid the cost-of-living crisis.
But the Prime Minister says the 19 per cent pay demanded by nurses is “obviously unaffordable”.
After thousands of ambulance workers took to the picket line in December, more industrial action has been scheduled for this month. Unison, a union representing workers, said the fresh strikes on January 11 and 23 are a direct result of the government’s “repeated refusal” to negotiate improvements to NHS pay this year.
Steve Barclay, the Health Secretary, caused fury among union leaders by saying they had taken a “conscious decision” to harm people.
Christina McAnea, Unison's general secretary, called on Mr Barclay to stop his “insults and fibs” and instead hold “proper talks” with union bosses on NHS pay.
“Speeding up next year’s pay review body process won’t solve the current dispute, which is about the pitiful amount the government gave health workers this year,” she said. “The government must stop using the pay review body as cover for its own inaction. This year’s pay rise simply wasn’t enough to halt the exodus of staff from the NHS.”
Junior doctors in England will also be balloted for strike action next week.
High flu rates
The number of people with flu in NHS hospitals in England alone has jumped by 80 per cent compared with the same period last winter.
Scotland, Wales and Northern Ireland have also been hit by high numbers of hospital admissions due to flu.
Saffron Cordery, NHS Providers’ interim chief executive, called the trend “worrying” and said it had contributed to “unacceptably high bed occupancy rates, which make it much harder to ensure safe high quality care.”
Matthew Taylor, chief executive of the NHS Confederation, said that coupled with Covid-19 infections, rising flu rates were placing additional strain on the NHS.
He said “high rates of flu and Covid which have more than doubled”, delays in hospital discharges and the aftershocks of strikes “are compounding the longer-term issues of over 130,000 NHS vacancies”. He also blamed 10 years of “lack of investment” in the service and “an elective backlog which continues to grow past seven million people” for the crisis.
The coronavirus crisis battered the NHS for two years and resulted in routine surgeries being postponed.
As a result, waiting lists have swelled and many patients have spent years enduring inaction and uncertainty.
But due to the unprecedented nature of the current crisis affecting the NHS, doctors have argued that further non-urgent procedures should be pushed back to free up capacity in hospitals.
Ms Cordery, from NHS Providers, said the nurses’ strike last month forced thousands of procedures to be called off.
“In terms of things like routine operations, so far we've heard that probably between around 40 to 60 per cent of those routine operations have been cancelled in places where the strikes were held.”
Prof Galloway said further cancellations “as a temporary measure” would help ease pressure on the NHS. He argued this approach would free up “the staff and space used to run additional wards so that A&E departments no longer have patients in corridors.”