September 12th 2024.
A visit to the A&E can be a daunting experience for anyone, but for some, it can also be a matter of life and death. Unfortunately, this is the reality for many patients in A&E departments across the country. As a junior doctor, it pains me to admit that our A&Es are not safe. The truth is, they are distinctly unsafe and many patients are unaware of the risks they face.
I wasn't surprised when I read about the 250 needless deaths that occur each week due to long wait times in A&E. It's a statistic that has become all too familiar. The recent report by Lord Darzi only confirmed what many of us already knew - the NHS is in a critical condition. We are falling short of targets for cancer, A&E, and hospital treatments, which has led to poor survival rates for diseases like cancer and heart disease.
Lord Darzi himself was shocked by the state of our nation's health. As someone who has worked in the NHS for over 30 years, he was taken aback by what he found during his investigation. Sadly, this is the reality that we, as junior doctors, face day in and day out.
In some A&E departments, teams are faced with 13-hour wait times, and the waiting rooms are filled with patients suffering from heart attacks, brain bleeds, and excruciating pain. And this is all before our shifts have even started. According to a recent analysis by the BMA, the waiting time in A&E has reached a crisis point. In July 2024, the number of patients waiting over 12 hours for an emergency admission was 81 times higher than in July 2019 - and this is considered to be an underestimate.
Sadly, this is not just a problem in one hospital. Other doctors have told me that the state of A&E is horrific across the country, with no sign of improvement. In 2012, less than 10% of patients waited over four hours in major A&E departments. Now, that figure is closer to 50%. It's not uncommon to see young women with ectopic pregnancies waiting for hours in the waiting room before medical staff realize just how serious their condition is.
It's not just the long wait times that are a cause for concern. Patients with strokes are not being diagnosed quickly enough, which means they miss the ideal treatment window for removing a clot in their brain. Instead, they are given medication, which is not as effective. In some cases, life-saving treatments are being carried out on the floor of the emergency department due to a lack of space. While the patient may survive, the healthcare staff are left physically and emotionally drained.
As A&E staff, we know that we are not getting to our patients quickly enough. It's an exhausting feeling, especially when we are struggling to provide even the most basic human rights to our patients. In the past, these excessive wait times would have been escalated, and managers would have been in the department to address the issue. A&E departments might have declared a major incident or asked for an ambulance divert. But now, there is nowhere to divert patients to because all other hospitals are facing the same problem.
A&E staff have become used to saying, "I did what I could" instead of "I did what I should." We are losing patients when their deaths could have been prevented, and it's heartbreaking. While other hospital wards can close their doors when they have no more beds, A&E does not have that luxury. We have to make do with what we have, and it's not enough.
Nurses who should be focused on providing emergency care to patients are also doing the work of ward staff for those who have been waiting in A&E for over 24 hours. These patients are often left in corridors with no privacy, dignity, or regular monitoring. As healthcare professionals, we apologize to our patients, their families, and our colleagues, but we know that there is very little we can do.
It's not just the staff who are affected by the current state of A&E. Patients and their relatives are understandably upset and frustrated. They have rarely had a positive experience in emergency medicine in recent years, and all we can say is, "We're sorry."
One doctor recently told me, "I feel an increasing sense of impending doom, knowing that somewhere in the department, someone is getting really sick, and I can't guarantee that I'll identify them, protect them, or give them the appropriate care they need." This is the harsh reality of the current situation in A&E.
According to the Darzi Report, the health of the nation has deteriorated over the past 15 years. Factors like poor housing, low income, and insecure employment have all contributed to this decline in health. As a result, the NHS is facing a rising demand for healthcare from a society that is in distress. It's clear that the NHS needs more investment in order to provide better care for its patients. Our A&E departments are in critical condition, and it's time for urgent action to be taken.
In some A&E departments, the situation is dire. Teams are struggling with wait times that can stretch up to 13 hours. And it's not just the wait times that are concerning. Our A&Es are unsafe, a fact that patients are often unaware of. As a junior doctor, it pains me to say this, but it's the truth. I wasn't surprised when I read about the 250 unnecessary deaths per week due to long wait times. And the recent report by Lord Darzi only confirms what many of us in the medical field have known for a while now.
According to the report, the NHS is in a critical condition, failing to meet targets for cancer, A&E and hospital treatments. This has resulted in poor survival rates for diseases like cancer and heart disease. Lord Darzi himself said that he was shocked by the state of the nation's health, despite having worked in the NHS for over 30 years. And as a junior doctor, I can attest to the fact that this is our reality every single day.
In some A&E departments, the waiting room is filled with patients suffering from heart attacks, brain bleeds, and excruciating pain. And they are all waiting to be seen, even before our shifts have begun. According to a recent analysis by the BMA, the waiting time in A&E has reached a crisis point. In July 2024, the number of patients waiting over 12 hours for emergency admission was 81 times higher than it was in July 2019. And this is only an underestimate, as other doctors have told me.
Sadly, this is not just an issue in certain A&E departments. It's a nationwide problem. In 2012, less than 10% of patients waited over four hours in major A&E departments. Now, that figure is closer to 50%. And it's not just the wait times that are concerning. We often see young women with unknown ectopic pregnancies waiting for hours in the waiting room before their condition is even detected. This delay in diagnosis can have serious consequences, as patients with strokes who are not seen quickly enough can miss the ideal treatment window for removing a blood clot in their brain.
I remember one incident where a young man had to receive life-saving treatment on the floor of the emergency department because there was no space. While he survived, the same cannot be said for the healthcare staff who have to work in these conditions every day. We know that we're not able to reach our patients as quickly as we should, and it's exhausting. We're constantly fighting to provide the basic human rights to our patients, which should be a given in any healthcare system.
In the past, when wait times reached such critical levels, there were measures in place to escalate the situation. Managers would be present in the department, A&E would declare a major incident or ask for an ambulance divert. But now, there's nowhere to divert patients to because all other hospitals are facing the same issue. As a result, A&E staff have become accustomed to saying, "I did what I could" instead of "I did what I should."
It's heart-wrenching to see our patients suffer and even lose their lives, knowing that it could have been prevented. Hospital wards can close their doors when they have no more beds, but A&E doesn't have that luxury. Instead, we try to do what we can with the limited resources we have. And it's not just the medical staff who are affected. Nurses, who should be focusing on providing emergency care, are also taking on the work of ward staff for patients who have been waiting in A&E for over 24 hours. They have to deal with the fact that their patients are put in corridors without any dignity, privacy, or proper monitoring.
It's a difficult situation for everyone involved. Patients and their loved ones are understandably upset and frustrated. They rarely have a positive experience in emergency medicine these days, and all we can say is "we're sorry." One doctor recently told me that they feel an increasing sense of impending doom, knowing that somewhere in the department, someone is getting very sick, and there's no guarantee that they'll be able to identify them, protect them, or give them the appropriate care they need.
The Darzi Report highlights some key findings that confirm the dire state of our healthcare system. It reveals that the health of the nation has deteriorated, with more years being spent in ill health. And the factors that contribute to poor health, such as inadequate housing, low income, and job insecurity, have only worsened in the past 15 years. This has resulted in a rising demand for healthcare from a society that is struggling.
It's clear that the NHS needs more investment to provide better care for our patients. As a junior doctor, I hope that our voices are heard and that the necessary changes are made to ensure the safety and well-being of our patients. We cannot continue to lose lives due to long wait times and inadequate resources. It's time for action.
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