Patients’ lives at risk in NHS hospital wards on brink of collapse claim Doctors
Patients’ lives are at risk in NHS hospital wards that are “on the brink of collapse” due to a critical shortage of out of hours doctors and growing numbers of the elderly.Some hospitals narrowly avoid a “catastrophe” every weekend, research by the Royal College of Physicians has found, because doctors’ shifts are limited by the European Working Time Directive and they do not want to work anti social hours.
Some are “struggling to cope” with the volume of older patients. Many are discharged in the middle of the night or shunted around “like parcels” to free beds for new arrivals.
If the problem is not tackled there will be more tragedies like the Mid Staffs scandal, in which up to 1,200 mainly elderly patients died from substandard care. A radical reorganisation of the NHS is needed, according to the college. It may include shutting the worst-performing hospitals to expand care at better ones, with more staff coverage at nights and weekends.
The Hospitals on the Edge report warns that:
- Four in 10 doctors surveyed said that staff shortages were jeopardising patient care
- One in four was concerned about the impact of the Working Time Directive, with one warning that “weekends and bank holidays function on a skeleton staff of doctors – very dangerous”
- Doctors are reluctant to work unsociable hours, leaving one in 10 consultant posts in emergency medicine vacant
- Over-65s account for seven in 10 beds, but the “the system continues to treat older patients as a surprise, at best, or unwelcome, at worst”.
The report notes that the number of beds in acute and general wards has fallen by a third over the past 25 years, while patients have increased. Beds have been cut as better care has led to shorter stays.
Dr Andrew Goddard, medical director for the college’s workforce unit, said: “Many hospitals run a traffic light system for their status: they are green if they are taking in patients; amber if they need to be a bit more careful; red for full or black if they are shut.
“What we’ve seen over the past year or so is that a number of hospitals are on red alert or black alert. A black alert used to be a once-in-a-lifetime thing. Now hospitals are on black alert three or four times a year.
“This has been coming on for a while. The system can’t cope much longer, and we need to radically rethink how we provide the care for acute medical patients, particularly the elderly.”
Prof Tim Evans, of the college’s future hospital commission, said that the eurocrats’ Working Time Directive, which limits doctors to a 48-hour week, was a “huge issue”.
Many doctors have complained that it has led to gaps in rotas, compromising patient safety, and prevented juniors from acquiring necessary experience.
He said that employment contracts for junior doctors reduced flexibility on working hours and needed to be renegotiated. Prof Evans said: “That leads to fragmented care and tragically to a lack of compassionate care, with staff rushing between patients, firefighting. Acute wards are on the brink of collapse.”
He warned: “There will not be some cataclysmic overnight explosion but there will be a gradual increase in the sorts of tragedies that we’ve heard about at Mid Staffs.”
Sir Richard Thompson, president of the college, said: “One doctor told me that his trust does not function well at night or at the weekend and he is ‘relieved’ that nothing catastrophic has happened when he arrives at work on Monday morning. This is no way to run a health service.”
Suzie Hughes, chairman of its patient and carer network, said that during a recent hospital stay she underwent five ward changes “all of which took place after midnight”.
She added: “All routine blood tests were done at approximately 3am as the junior doctors only had time to do them then. It is clearly unacceptable.”
Tags: Doctors, Health Professionals, nhs cutbacks, NHS Deaths, out of hours, preventable crisis, red tape, waiting times