NHS is 'overcrowded and short-staffed'

 

Hospitals are so full that elderly patients are being discharged in the middle of the night and routine blood tests are being conducted at 3am, the Royal College of Physicians (RCP) has warned.

As bed spaces for acute care become increasingly under demand, patients are being turfed from ward to ward which is leading to a poor continuity of care, the RCP said.

Doctors on wards up and down the country are struggling to care for patients who require urgent or emergency care, according to a damning report, Hospitals On The Edge? The time for action.

As queues at the doors of accident and emergency wards increase, patients who are already admitted to the hospital are shipped from one ward to another "like parcels", to make bed space.

This is leading to fractured care and a lack of compassion that may occur as a consequence, RCP officials said.

A dwindling number of specialist medics working out of hours and staff shortages in key emergency care departments are putting strain on services.

One in 10 consultant posts in emergency medicine are currently vacant, the RCP said.

While the number of patients has increased, the number of beds in general and acute wards has fallen by a third in the last 25 years.

"Hospitals have filled up," said Dr Andrew Goddard, medical director for the RCP workforce unit.

"Many hospitals run a traffic light system for their status: they are green if they are taking in patients; they are amber if they need to be a bit more careful; red for full or black if they are shut.

"What we've seen over the past year or so is that a number of hospitals are on red alert or black alert.

"A black alert used to be a once-in-a-lifetime thing. Now hospitals are on black alert three or four times a year.

"This has been coming on for a while. We have managed to cope with it but the system can't cope much longer, and we need to radically rethink how we provide the care for acute medical patients, particularly the elderly."

Suzie Hughes, chair of the RCP's Patient and Carer Network, said: "I myself had an experience of staying in hospital recently. It was a prolonged stay and I had five different ward changes, all of which took place after midnight.

"All routine blood tests were done at approximately 3am as the junior doctors only had time to do them then.

"It is clearly unacceptable and we need to change things."

The RCP said "radical reorganisation" of the health service is needed if it is to attain high standards of care for patients.

Senior RCP officials suggest that one option could be to shut hospitals, with a bigger focus on community care, so that people could get hospital services at bigger centres 24 hours a day seven days a week.

Professor Tim Evans, lead fellow the RCP's Future Hospital Commission, said: "If we want patients to see compassionate care seven days a week in all specialities and to have their care coordinated by named doctors then it is likely that we will not have the resources to do that on all hospitals sites to the level that we would wish."

If action is not taken, there could be a reproduction of the tragic events at Mid Staffordshire NHS Foundation Trust where as many as 1,200 patients may have died unnecessarily because of poor care.

"There will not be some cataclysmic overnight explosion but there will be a gradual increase in the sorts of tragedies that we've heard about at Mid Staffs," he said.

"All hospital inpatients deserve to receive safe, high-quality, sustainable care centred around their needs and delivered in an appropriate setting by respectful, compassionate, expert health professionals. Yet it is increasingly clear that our hospitals are struggling to cope with the challenge of an ageing population who increasingly present to our hospitals with multiple, complex diseases.

"We must act now to make the drastic changes required to provide the care they deserve."

RCP president Sir Richard Thompson said the research unveils "deep-seeded problems" within acute medical services.

"As I go around the trusts around the country I find a common picture that is of increasing strain on the acute medical services wherever you go in the country.

"If we are going to look at changes in services it is very important that changes are led by clinicians and don't have political intervention.

"One doctor told me that his trust does not function well at night or at the weekend and he is relieved that nothing catastrophic has happened when he arrives at work on Monday morning. This is no way to run a health service. Excellent care must be available to patients at all times of the day and night.

"We call on government, the medical profession and the wider NHS to work together to address these problems."

Alzheimer's Society chief executive Jeremy Hughes said: "People with dementia occupy a quarter of hospital beds, yet constantly we hear that they face poor quality care from staff not trained in dementia care.

"Bearing this in mind, these latest findings are alarming but, unfortunately, not surprising.

"It is painfully evident that the healthcare system stands on the brink of crisis.

"People with dementia are going into hospital unnecessarily, staying in too long and coming out worse. Supporting people to live well at home and reducing the length of time a person stays in hospital can both improve quality of life and save the NHS hundreds of millions per year."

Health Minister Dr Dan Poulter added: "We are modernising the NHS so it can continue to do more and improve care - putting doctors and nurses, those who best understand the needs of patients, in charge of improving the NHS.

"To properly provide dignity in care for older people, we need to see more care delivered at home and in the community.

"Already we are seeing more patients treated as day cases and more patients receiving improved care outside hospitals.

"We are also introducing a new friends and family test, where patients answer a simple question - whether they'd want a friend or relative to be treated in a particular hospital in their hour of need. By making those answers public we're going to give everyone a really clear idea of where to get the best care - and drive other hospitals to raise their game."

PA

Life and Style
life
Arts and Entertainment
Diana from the Great British Bake Off 2014
tvProducers confirm contestant left because of illness
News
Brad Pitt and Angelina Jolie reportedly married in secret on Saturday
peopleSpokesperson for couple confirms they tied the knot on Saturday after almost a decade together
Life and Style
Chen Mao recovers in BK Hospital, Seoul
health
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Client-Side web developer (JQuery, Javascript, UI, JMX, FIX)

    Negotiable: Harrington Starr: Client-Side web developer (JQuery, Javascript, U...

    Structured Finance

    Highly Competitive Salary: Austen Lloyd: CITY - An excellent new instruction w...

    SQL Server Developer

    £500 per day: Harrington Starr: SQL Server Developer SQL, PHP, C#, Real Time,...

    C#.NET Developer

    £600 per day: Harrington Starr: C#.NET Developer C#, Win Forms, WPF, WCF, MVVM...

    Day In a Page

    Ukraine crisis: The phoney war is over as Russian troops and armour pour across the border

    The phoney war is over

    Russian troops and armour pour into Ukraine
    Potatoes could be off the menu as crop pests threaten UK

    Potatoes could be off the menu as crop pests threaten UK

    The world’s entire food system is under attack - and Britain is most at risk, according to a new study
    Gangnam smile: why the Chinese are flocking to South Korea to buy a new face

    Gangnam smile: why the Chinese are flocking to South Korea to buy a new face

    Seoul's plastic surgery industry is booming thanks to the popularity of the K-Pop look
    Salomé's feminine wiles have inspired writers, painters and musicians for 2,000 years

    Salomé: A head for seduction

    Salomé's feminine wiles have inspired writers, painters and musicians for 2,000 years. Now audiences can meet the Biblical femme fatale in two new stage and screen projects
    From Bram Stoker to Stanley Kubrick, the British Library's latest exhibition celebrates all things Gothic

    British Library celebrates all things Gothic

    Forthcoming exhibition Terror and Wonder: The Gothic Imagination will be the UK's largest ever celebration of Gothic literature
    The Hard Rock Café's owners are embroiled in a bitter legal dispute - but is the restaurant chain worth fighting for?

    Is the Hard Rock Café worth fighting for?

    The restaurant chain's owners are currently embroiled in a bitter legal dispute
    Caribbean cuisine is becoming increasingly popular in the UK ... and there's more to it than jerk chicken at carnival

    In search of Caribbean soul food

    Caribbean cuisine is becoming increasingly popular in the UK ... and there's more to it than jerk chicken at carnival
    11 best face powders

    11 best face powders

    Sweep away shiny skin with our pick of the best pressed and loose powder bases
    England vs Norway: Roy Hodgson's hands tied by exploding top flight

    Roy Hodgson's hands tied by exploding top flight

    Lack of Englishmen at leading Premier League clubs leaves manager hamstrung
    Angel Di Maria and Cristiano Ronaldo: A tale of two Manchester United No 7s

    Di Maria and Ronaldo: A tale of two Manchester United No 7s

    They both inherited the iconic shirt at Old Trafford, but the £59.7m new boy is joining a club in a very different state
    Israel-Gaza conflict: No victory for Israel despite weeks of death and devastation

    Robert Fisk: No victory for Israel despite weeks of devastation

    Palestinians have won: they are still in Gaza, and Hamas is still there
    Mary Beard writes character reference for Twitter troll who called her a 'slut'

    Unlikely friends: Mary Beard and the troll who called her a ‘filthy old slut’

    The Cambridge University classicist even wrote the student a character reference
    America’s new apartheid: Prosperous white districts are choosing to break away from black cities and go it alone

    America’s new apartheid

    Prosperous white districts are choosing to break away from black cities and go it alone
    Amazon is buying Twitch for £600m - but why do people want to watch others playing Xbox?

    What is the appeal of Twitch?

    Amazon is buying the video-game-themed online streaming site for £600m - but why do people want to watch others playing Xbox?
    Tip-tapping typewriters, ripe pongs and slides in the office: Bosses are inventing surprising ways of making us work harder

    How bosses are making us work harder

    As it is revealed that one newspaper office pumps out the sound of typewriters to increase productivity, Gillian Orr explores the other devices designed to motivate staff