Leading Doctor Warns that NHS Faces Winter Meltdown

A leading doctor had suggested that the health service will face the potential of meltdown during the winter months.

Dr Mark Holland, president of the Society for Acute Medicine, suggested that the resilience of medical units was being severely tested by the existing NHS climate.

This verdict follows closely on from the assertion from chief executive of NHS Providers, Chris Hopson, that it would be impossible for the government to achieve its seven-day NHS target without further cash injection.

Holland suggested that potentially fit patients not being discharged from hospital, often described as bed blocking, can be considered a national emergency, and must be significantly addressed if winter chaos is to be avoided.

“Hospitals where performance is already weak will find it very difficult to cope during the winter and that will lead to pockets of meltdown. At the core of the issues facing the NHS is the rapidly increasing number of delayed discharges. The figures are spiralling and are fast becoming disastrous. If hospitals cannot discharge patients then the system comes to a halt. We need an overhaul of the discharge and social care process nationally so we can release pressure on front-of-house services in our hospitals – it is a national emergency.”

Figures for July show the equivalent of 184,188 days were lost due to delayed discharges, the highest on record.

Estimates indicate that the figure across the year could reach 2.7 million bed days lost.

The audit, which covered 94 units and 4,140 patients, showed 81% of patients were seen by a consultant within the target, 69% by a competent decision-maker within four hours and 69% had an early warning score recorded on arrival.

However, only 41% of patients received all three.

Holland commented that the findings were encouraging in some respects, but that the skill and persistence of healthcare workers was set to be severely tested.

“The findings are that, while we are still doing well on average and some units are doing very well, there is a spread and variance in what we achieve and, overall, performance has dipped over the last three years. This tells us that, despite the brilliant work of acute medicine practitioners to maintain quality and safety – and there are some fantastic examples of staff going above and beyond – our resilience is being put to the test like never before and that is not sustainable in the long term.”

MPs in Westminster later appeared before the Commons health committee in order to explain the situation that the NHS faces over the winter months.

Professor Keith Willett, director for acute care at NHS England, and Pauline Philip, urgent and emergency care director, were among those attending the Westminster session.


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