Analysis: More honesty about the crisis facing the NHS is urgently needed

Health correspondent Shaun Lintern considers the pressure the NHS is under from coronavirus

Tuesday 05 January 2021 21:37
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<p>Hospitals and ambulance services across England are being pushed to the brink</p>

Hospitals and ambulance services across England are being pushed to the brink

In the past two weeks, hospitals in London and across the southeast have had to declare major incidents, cancel operations and transfer patients to NHS trusts hundreds of miles away.

Some have struggled to deliver the volume of oxygen needed by patients sick with the coronavirus who are being cared for on makeshift wards set up in any spare room the hospitals can find.

Ambulances have queued outside hospitals, facing six-hour delays to hand over patients. Even though hospitals have expanded their numbers of beds massively, they still cannot find enough room.

This is not a normal winter for the NHS. Many staff on the ground report extreme working conditions. Nurses have described struggling to sleep at night, while others have revealed they suffer vivid, nightmarish dreams about them and their loved ones being in intensive care.

NHS England’s national medical director, Steve Powis, told reporters on Monday that the NHS was under “immense pressure” as he marked the beginning of the rollout of the Oxford/AstraZeneca vaccine.

On Sunday, in comments that angered many of his staff, the chief executive of the London Ambulance Service, Garett Emerson, said the service was just about coping.

The four chief medical officers for the UK issued a statement warning that there was a “material risk” the NHS could be overwhelmed within the next 21 days.

In London and the southeast, the NHS was already overwhelmed over the Christmas weekend and it has only worsened since. England now has 40 per cent more patients in hospital than there were at the peak of the first wave of the virus in April.

In Kent, the number of critical care patients has far exceeded normal levels, with clinicians telling The Independent there were patients on wards who they would normally have in intensive care but that there just wasn’t space.

Hospitals are desperately short of staff and nursing to patient ratios have been stretched to unsafe levels, with large London hospitals appealing to staff to work extra shifts. Leave has been cancelled for many, and surgeons have been drafted in to help out with basic care tasks on wards so that nurses can be freed up to do their expert work.

And it’s not just London: hospitals in Lincolnshire declared a critical incident on Tuesday because of the number of coronavirus patients being admitted. Hospital bosses in Birmingham have issued warnings over the pressure on nurses in critical care departments.

For many frontline NHS staff, the hints of extreme pressure that chief medics and others have given don’t go far enough. Staff feel a growing resentment towards their own executives over what some see as an unwillingness to publicly accept the situation the NHS is in.

It is perhaps politically unpalatable for senior figures to openly admit the health service is unable to cope. But coronavirus denialists and lockdown sceptics are filling the vacuum and perpetuating the myth that the NHS is struggling no more than it always does in winter.

The fact is that the health service went into this crisis weaker than it needed to have been. Successive years of underfunding left it with fewer beds and staff than most western European nations.

The public don’t need the truth hidden from them. NHS staff want to see real leadership from their bosses. No health service could withstand the onslaught from the coronavirus unscathed.

Being more honest about the weaknesses of the health service and the reality of what is happening is urgently needed. It would silence the denialists and simultaneously show staff that the leadership get the situation they are in.

It would also serve to make the case for a properly resourced health service in the longer term.

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