Carl Heneghan

It’s time to fix the NHS’s looming winter crisis

My patient has sepsis. The window for treatment is short; in less than an hour, he could die. In urgent care, the direct line to ambulance control bypasses 999: it lets the call handler know a doctor requires urgent attention for a sick patient. Ten minutes: no response. I’m on a second phone to central dispatch: what is going on? A critical incident has been called; the service is overwhelmed. Finally, after 15 minutes, the phone answers and help is on its way. 

Worryingly, this is far from an isolated incident. Last week, it was reported that an ambulance service sent a taxi to a GP practice in Bristol to collect a patient with a broken hip after a nine hour wait. In October, the average NHS response time for a category two (emergency) call rose to 54 minutes; this is more than double the national standard of 18 minutes. Such delays, in situations in which every minute counts, can cost lives. They also raise questions as to whether our emergency services can cope with what is coming this winter.

Such delays, in situations in which every minute counts, can cost lives.

If it can’t, it won’t be for lack of money. The NHS budget was £33 billion when Tony Blair came to power in 1997; it has quadrupled to over £150 billion. The NHS capacity crisis, however, has persisted throughout. General and acute bed numbers fell from 181,000 beds in 1987 to just over 100,000 before the pandemic. Despite the backdrop of a steadily ageing population: the number aged 85 or over is predicted to double in 20 years.

Virtually all health secretaries have faced the repetitive existential crisis with rising winter respiratory pathogens such as flu and now Covid with under-resourced and understaffed capacity.

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