NHS hospitals now so overwhelmed patients could die, says top doctor

Hospitals are now so overwhelmed patients could die, a doctors’ leader said on Thursday, adding that the NHS is now in an “eternal winter”.

The stark warning from doctors involved in acute care came after figures showed record numbers of sick people are having to wait longer than they should for treatment, with the NHS admitting it has missed almost all its key waiting time targets in the same month for the first time in hospitals in England.

During January a total of 212,136 A&E patients were not treated within four hours, 17,392 did not have their x-ray, CT or MRI scan inside six weeks and 51,545 had to wait on a trolley for at least four hours before getting a hospital bed.

“A government which has the laudable aim of reducing hospital deaths by 11,000 must recognise overcrowded hospitals that are full of sick patients in overstretched medical units will contribute to avoidable deaths,” said Dr Mark Holland, president of the Society for Acute Medicine (SAM).

“The ability to deliver acute medical care is reaching crisis point and any other crisis affecting our society would be acknowledged and addressed. The volume of patients and disease severity is so much that we are now functioning at the edge of what is possible,” he added. “The NHS is running out of steam.”

The SAM represents over 1,000 NHS doctors who look after adult patients admitted as an emergency after treatment in a hospital’s A&E unit.

Holland claimed inadequate funding of the NHS and difficulties recruiting staff had left it struggling to cope with demand for treatment so relentless that it is facing a state of “eternal winter”.

He was responding to the grimmest set of monthly performance figures NHS England has posted since records began. The multiple breaches of waiting time targets they disclosed also showed that cancer patients did not get supposedly urgent treatment fast enough, and that ambulance services failed to get a 999 vehicle to many patients facing life-or-death emergencies.

Only 83% of those who attended a hospital-based A&E unit in January were admitted, transferred or discharged within the required four hours – the worst performance ever on that measure. The NHS constitution stipulates that 95% of such patients should be treated within that time frame.

North Middlesex University Hospital NHS Trust in London had the worst performance against the four-hour target – just 66.4% – though the University Hospital of South Manchester trust was not much better, recording a rate of 71.7%.

Heidi Alexander, the shadow health secretary, said the figures were “shocking”. She accused ministers of pushing the NHS into “a crisis of their own making” by cutting nurse training posts and social care for those still living at home, especially the elderly.

“Waiting time targets exist to provide swift access to care and they have now been missed so often that failure has become the norm,” she said.

Dr Fran Woodard, executive director of policy and impact at Macmillan Cancer Support, said “urgent improvements” were needed to ensure cancer patients received prompt treatment after being referred by their GP. “Waiting a long time to be diagnosed and to start treatment is the last thing people need at what is already an incredibly tough time,” she said.

The charity is “bitterly disappointed” that the 62-day cancer treatment target has been missed for 21 of the last 24 months. More than 2,000 patients faced such delays in January, figures show.

Among trusts that treated at least 10 patients for cancer for the first time in January, the one that treated the fewest within 62 days was the widely admired University College London hospital trust. It managed to treat just 59.1% of such patients within the target time.

The Department of Health dismissed Holland’s fears about possible patient deaths, accused him of exaggerating the problems in the NHS and stressed that hospitals are facing an unprecedented and growing demand for care.

“This is patent nonsense, and does a disservice to our hospitals and staff coping well under huge pressure. Seeing 111,000 more people in A&E in under four hours last month, treating more patients for cancer than ever before and slashing the number of people who have to wait more than a year for treatment,” said aspokesman.

A&E attendances were 10.1% higher – or 111,000 people more – in January than in the same month in 2015, while the number of patients needing to be admitted as an emergency rose over the time period by 4.6%. NHS England said that it was still treating “the vast majority of patients within four hours”.

Richard Barker, its interim national director of commissioning operations and information, said that 1.9 million people had sought A&E care in January. “Against this backdrop, it’s not surprising hospitals saw a dip in their A&E performance, and it is a credit to all those working in emergency care that we are still admitting, treating and discharging almost nine out of 10 patients within four hours,” he said. “Winter pressures have come late this year with a sustained cold period and an increase in seasonal infections.”

January also saw a record number of hospital bed days – 103,491 – lost to “delayed discharges of care”. These involve patients who are medically fit to go but cannot be discharged because social care is not in place to allow that.

Ray James, president of the Association of Directors of Adult Social Services, said that delayed discharges would cost the NHS £3.3bn between now and 2021 and that extra funds for social care promised by ministers was “too little and too late”.