AIBU to wonder what the heck is going on in hospitals right now??

[Rinoachicken]

Before I start, I want to make it clear I am NOT blaming the hospital staff in any way.

13 hospitals have declared state of emergencies or whatever it is.

Why is everyone suddenly descending on A&E all over the country all in the same week? Has there been an outbreak of something I don't know about?

I don't get it. A&E is always stretched to the limit, but Why this sudden crisis all over the country?

Am I missing something??

Being an ex-A&E nurse, I think this has been bubbling under for years & often internal major incidents should've been called but weren't, now, attendances have rocketed (20k a week more than last year even) & with one hospital being brave enough to call it & not face criticism/have the health sec slam them others have followed to ensure they can take the measures needed to deal with the situation (calling in extra staff, central management of beds & cancellation of elective surgery/out pt clinics).

...forgot to add - you're NBU

It cannot be a coincidence that this comes at a time when GPs' Clinical Commissioning Groups are in full swing, and people are finding it harder to see a doctor, walk ins are staffed predominantly by nurses (excellent, but not doctors), and 111 advice is frequently to 'see a doctor'.

Presumably due to 2 consecutive bank holiday" weekends "with fewer gp appointments available as a reult

I was thinking the same thing OP. I don't get it and the situation is very worrying.

Flu season and alot of nasty bugs out there this year on a system thats over stretched.

I don't remember this ever happening before though?

My local paper is reporting a lot of people in the trolley queue, and waiting for ambulances, were patients with fractures. In pain.

Glad to see I'm not the only one!

That's a good point about once one has done it the others feel more able to do so, and about the GP commission thing, didn't realise that. The cyclical side of me wonders if this has anything to do with it being election campaign kick off week...

It been flu season surely can't be the reason, there is flu season every year after all and having flu (for most people) shouldn't mean a trip to A&E!

Cynical even! (I'm not circular, on any side!)

It's also the result of cost-cutting. They're running units on bare bones of staff. The unit I worked in had 18 ground floor staff when I joined, as people left they weren't replaced, they reassess, say it could be run with 17 staff, then 16, then 15- by the time I left it was running on 13 people absolutely stretched to the limit. So people were leaving....

Might not be A+E itself though. If other departments are running on skeleton staff, the poor old Paeds doctor has her own patients, ward to cover, then has to go down to A+E when there's a paeds consult. Same for ortho, dermatology, geriatrics, x-ray. So people sit in A+E waiting for their consult before they can be discharged to a ward, home, clinic, GP...

I think a lot of people have used a and e because they can't get into the GP, a lot of people can't get into the GP because too many people don't self medicate/use the pharmacist. We as a nation certainly don't help the situation.

Is it due to cold weather, slips nice? (Fractures mentioned by pp?) but surely there is an increase inepweather related incidents every year? And flu season and the nastybug that's going around. Plus less gp appointments?

I don't know, just throwing some ideas around, but seems scary!

All these points are valid and certainly long term reasons for the crisis

But I still don't get why it's reached emergency major incident crisis level all in he same week Al over the country??

Please excuse the poor spelling - stupid phone!

Well I know around here there is an awful flu like bug which I would imagine would be adding the stress for the system

HUGE cuts to social care over the last three years.

Social care - feeding and cleaning people in their own home, giving medicine, transporting to the GP, being able to spot a deterioration early - is a comparatively cheap and very efficient way to look after people.

Take that away, and people deteriorate over time. They also become suddenly ill from mistakes with medicine or inability to keep themselves and their environment clean.

And end up in hospital.

I posted on MN predicting this crisis back when the social care cuts were made.

My next prediction is some politicians will exploit the crisis, claiming it's proof the "NHS model can't work", and needs to be privatised even faster.

Hospital management initiate a major incident plan to formally notify of over capacity in hospital.basically demand exceeds ability to cope.too many patients in ambulances awaiting assessment and treatment. If an ambulance cannot drop a patient off at a&e and then respond to next call,the ambulance can't achieve turnaround.turn around is dropping pt off,and responding to next call.insbility to quickly respond to next job increases waiting/response time. So the guidelines are resoond in set time for each category of call,but the reality is ambulance remain ststiknary at a&e with a pt inside

The impact on staff, is that the staff can be required to come to work on day off.work additional shifts or extra hours to cover demand

Planned scheduled ops will be cancelled and other work prioritised in order to meet immediate demands and discharge pts

In winter, certain respiratory conditions are exacerbated and this means more admissions
Norivirus is seasonal
Xmas party season,more alcohol related presentation to a&e
GP have been closed so more walk in clients
If social care package are complex or delayed this can lengthen admission time,and delay discharge

My local hospital (one of the ones in the state of emergency) hasn't been able to recruit enough A &E staff for the past couple of years, to the point where they had to downgrade the unit overnight to minor injuries only (I think). Anything else is diverted to the next nearest A&E unit. I can imagine the reduction in staff numbers would have an impact though.

Also, GP appts are crazy at the moment. I can book mine online, I needed to book a routine one for later this month, on Sunday there were no regular appointments available at all for this week (they usually have a few available at least). I can imagine people (wrongly) in desperation turning up at A&E instead.

Election this year.

Everything you read about the nhs from now until May will be because of the upcoming election.

No point criticising before you can make political gain from it

Winter pressures of more viruses etc circulating, a rapidly aging population with complex and chronic conditions, NHS services having to make yearly cost savings, social care having to do the same, shortages of appropriately skilled workers, GPS unsure whether their key role is as provider, commissioner or coordinator, a lack of understanding by the public of what A&E is for coupled with frustration when they can't get into the appropriate service quickly enough plus a looming election make a heady mix.

I work in a hospital (not one of the ones mentioned thankfully, but still struggling). There are several reasons for the current crisis

We (the NHS) are permanently on a knife edge of collapse, mainly due to under funding (4 yrs of Tory govt haven't helped this) which causes under staffing.

If you have less nurses and doctors (and allied health staff) you have to have less beds. More people get sick in winter, not just flu, so these beds are full pretty most of the time.

So when people rock up in A&E for what ever reason, if they need to stay in there is a wait for the bed manager to clear a bed rush someone else home.

Also if lots of the people in hospital or A&E are elderly and need social or nursing care to get them home there is less of this available (again because there is less money to pay for it).

The easy answer is to throw billions at the NHS, but then the country goes back into financial melt down (as in 2008) and were all fucked!!

Very short and slightly glib answer, but all this combined with 3 BH in 2 weeks and GP surgeries being closed for them has just caused what you see on the news. It's very similar every Christmas/New Year period, but most Trusts manage to keep it out of the media!!

The Professor of Emergency Medicine speaking on the Today programme this morning said it was largely not "inappropriate attenders" ie people with sniffles or low level long-term conditions who should be self medicating with paracetamol or seeing their GP; they are seeing a large number of elderly people with complex health needs who require hospital treatment - they need to be admitted, so beds have to be found for them. That means the last batch of ill people need to be discharged, so somewhere has to be found for them to go - it's a sign of issues in social care along with the frontline health system.

I think its only unusual in that its now a media story. DH is a surgeon and the hospital he works in frequently closes to new admissions and cancels elective surgery because of a lack of beds. I'm not sure at what stage it becomes declared an emergency.

Er, CMP, the financial meltdown in 2008 was caused by banks gambling and losing the bet. And started in the US and France.

Nothing to do with the NHS!