This was originally a Twitter thread, reproduced here so it can reach a wider audience.
I wish I could bring you good news. I wish I could tell you as the peak of Omicron passes we are regaining the capacity to treat the millions waiting for urgent and routine care. But, honestly, it has never been as bad as this.
There are streams of doctors and nurses raising the alarm. It is simply unsafe and patients are suffering. And yes, patients are undoubtedly dying due to the level of healthcare rationing currently in place.
“there’s a serious emergency in emergency care that is putting lives at risk…Waits for admission beyond 5 hrs increase the chances of a patient dying…since October there has now been over 100,000 12hr delays across the 40 UK sites participating in the project.” @RCEMpresident— Royal College of Emergency Medicine (@RCollEM) February 15, 2022
It is a sign of failure when we can’t provide routine care. Currently waiting lists are at 6.5 million for “routine” care.
It is a whole other kind of failure when we can’t provide semi-urgent care. Every month thousands more cancer patients join the queue waiting two months to start their cancer treatment. Imagine, you have cancer…you know it can spread…but you have to wait two months.
But now we enter a whole level of failure: the inability to provide urgent and emergency care.
I am finding it increasingly difficult to accept the lack of focus on the health care crisis that is Emergency care. Ambulance delays, patients held in ambulances, trolley stays & corridor care is becoming normalised in a truly shocking way. We must & should do better. @RCollEM— Katherine Henderson (@RCEMpresident) February 15, 2022
The effects are very real. The number of people dying in their own home has shot up through 2020 and 2021 (data pending for 2022).
And most of the excess death is in the under 65 age group.
I’m sorry, it is scary. It is dangerous for the public. But meanwhile this government just keeps spinning the truth and focusing on those targets that will get them votes.
As an ED Doctor puts it…
I wish anyone going into hospital in these times of such severe pressure, whether staff or patients, the best of luck.— Dr. Farbod (@EmergencyBod) February 17, 2022
It feels like it’s all I can offer at the moment.
But why, when Covid has been ‘defanged’ should the UK’s healthcare system be failing?
- The UK Government
- The lack of engagement from media
We are running on average with a ten percent increase in workload from acute Covid. That’s ten percent in a system that usually works with 2-3 percent margins of activity.
Before this winter, if we had hit November with a bed occupancy of over 85 percent (our safety level), panic would have ensued. In November 2021 we were already at 94 percent.
Then Omicron hit, took over 15 percent of our beds and led to 2,000 admissions per day. There is still 10 percent of medical beds taken up and still over 1,000 admissions per day.
But there are the other effects of Covid on healthcare.
We know that following admission to hospital with Covid that the use of healthcare by each patient increases 3.5 times for the foreseeable future. Similar, albeit higher than pneumonia, we expect around three years of this increased use for each patient. We have had over 600,000 Covid admissions.
We know heart-disease risk increases dramatically following Covid, more so with severe disease, but also with mild disease.
A massive study shows a long-term, substantial rise in risk of cardiovascular disease after a COVID infection https://t.co/jcqPaPlo3n— nature (@Nature) February 15, 2022
The rate of mental illness following Covid also dramatically increases.
Note the massive increase in mental health referrals:
This is concerning…— Dr Dan Goyal (@danielgoyal) February 17, 2022
The risk of acquiring a mental health disorder after Covid-19 is significant. > 50% higher than after the flu.
An impressive and painstaking study by @zalaly and colleagues. https://t.co/XNEOJlxtEn
We then have additional unspecified Long Covid cases; the consequences of prolonged lockdowns: delayed diagnoses, deconditioning, loneliness, poverty; and the other consequences of people being unable to access care – presenting late and being very unwell.
2. This UK Government
Meanwhile we have a government that has demonstrated they will do whatever they can to avoid doing anything to strengthen the NHS. Even during a pandemic.
They shrank the NHS by eight percent. Yes, during a pandemic with an extra 10+ percent of new patients. They bypassed GPs, pushing patients to commercial, non-clinical providers of Covid test and trace. They took the money for Covid and gave it to their mates: £36 billion to Test & Trace, £0.25 billion to GP services.
And now, when we are all screaming that we can’t provide basic emergency care to the public, they are talking about investing ‘NHS’ money in new technologies and ‘waiting list initiatives’, which they aim to be provided by the ‘independent sector‘.
We, the clinicians are saying the patients need X, and the politicians are yet again (as they did with Covid) overruling us and providing, not ‘Y’, but empty promises that will do absolutely nothing to improve patient care.
Undoubtedly, the biggest risk to patient safety right now is This Government: Johnson’s Government, a government the Tory party are supporting.
I’m afraid many media outlets are failing to hold the government to account. We have the highest ever cancer waits, A&E waits, operation waits, resignations and vacancies. And it seems this is not newsworthy to some outlets.
There are solutions. In fact, there are very simple solutions.
- Improve pay and working conditions for frontline staff. A 15 percent across the board pay rise (junior doctors, nurses, porters, secretaries, physical therapists, etc.); proper overtime pay; rest rooms; even a tea and coffee would be a start!
- Invest in more beds, not in more tech. We need a 10 percent increase in bed capacity just to “live with Covid”. And if we are to drive waiting lists down, then we will need more than 10 percent.
- We need to drive down urgent wait times first, then semi-urgent wait times (e.g. cancer), and then elective care.
The focus must be on public safety and harm reduction. As it stands this government’s policies are only going to increase harm to the public. Forcing a very stretched service to drive down election-losing waiting times only further comprises urgent and semi-urgent care.
This government is failing. They have failed to protect life and livelihood throughout the pandemic, and they are again failing now.
I will remind you, the majority of excess deaths are in those in the under 65 age bracket. We can’t allow incompetence and corruption to destroy any more lives.