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NHS pressures could cause staff ‘burnout’

Health service faces ‘a long winter’

Jo Carlowe

Friday, 11 March 2016

The NHS performance figures, revealing the services “worst ever” figures, have caused widespread dismay, with senior figures warning the pressures could lead to staff “burnout”.

Published yesterday, the data shows the worst ever performance in the first month of the year. A total of 212,136 patients waited more than the maximum four hours to be admitted, transferred or discharged from hospital A&E units. 

The number of patients waiting at least four hours on a trolley to be admitted reached 51,545 in January, up from 13,162 in January 2011 — a record high.

Hospitals only treated 83% of A&E patients within four hour, below the 95% target. And record number of cancer patients were not seen within set time limits. Only 81% of patients, had their first treatment for cancer, following GP referral, within 62 days, below the 85% target.

In addition, the largest number of patients ever waited longer than the standard 18 weeks for planned hospital care, such as cataract operations or hernias, and only 69.9% of Red 1 ambulance calls were responded to within the required eight minutes, below the 75% target. 

Commenting Dr Clifford Mann, President of the Royal College of Emergency Medicine, said the figures came “as no surprise to those working in A&E”.

“Our Members and Fellows report relentless pressure, so much so that this College is becoming increasingly concerned about the risk of burnout for the medical and nursing teams working so hard to deliver the service. We know that lengthy waits in emergency departments are consistently associated with excess and avoidable deaths.

“‘It is now routine for many staff to arrive at work faced with congested and overcrowded departments in which it is impossible to deliver best care. Similarly many leave work, hours after their agreed finish time, exhausted by the scale of the task.”

He added: “The College is in regular dialogue with the Department of Health and NHS England. Urgent action to increase capacity within A&E departments is the focus of these discussions.

“This is important, because international studies have consistently shown that lengthy waits in emergency departments are associated with increased deaths, lack of dignified care and stressful working conditions.”

Dr Fran Woodard, Executive Director of Policy and Impact at Macmillan Cancer Support, described the missed cancer waiting time targets as “bitterly” disappointing.

“It is now two years since one of the key cancer waiting time targets (62 day) was breached. The target has now been breached for 21 out of 24 months.

“We are bitterly disappointed that two years on this target is still being missed meaning that in January this year over 2,000 people with cancer waited longer than two months before starting vital treatment. More than half of trusts (58%) are currently failing people; clearly not enough has been done to make sure that cancer patients across the country experience swift referrals for treatments.

“Last year the cancer strategy for England was published, which was an acknowledgement that more needs to be done to support people affected by cancer. Yet here we are at this depressing milestone for waiting times, without a firm commitment to implementing what was recommended.”

She added: “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. We must see urgent improvements if the NHS has any hope of handling increasing pressures and giving people affected by cancer the best support possible to cope with this debilitating disease.”

NHS England, blamed record demand and the late arrival of winter. Richard Barker, Interim National Director of Commissioning Operations and Information, said: “We saw record demands on our frontline services in January with 1.9 million people walking through the doors of A&E. That represents an increase of 175,000 more patients compared with the same month last year, up by more than 10%. And 484,568 emergency admissions represent a similar hike, up by 4.6%.

“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 ten patients within four hours. Winter pressures have come later this year with a sustained cold period and an increase in seasonal infections. 

“We are working hard to support hospitals to deliver improvements in the Spring and remain fully committed to improving access and minimising waits for urgent and emergency care.”

John Appleby, Chief Economist at The King’s Fund, said: “These figures are symptomatic of the perfect storm through which NHS trusts are trying to steer – with pressures on services across the board. Most trusts are operating with very high bed occupancy which makes it difficult to respond to unexpected fluctuations in admissions. This is compounded by delays in discharging patients, which prevents beds being freed up for new patients. Today’s figures suggest it will be a long winter for the NHS.”

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