More than 200 people who died last week in England are estimated to have been affected by problems with urgent and emergency care, according to the president of the Royal College of Emergency Medicine.
Dr Adrian Boyle, who is also a consultant in emergency medicine, told BBC Radio 4’s Today programme that a failure to address problems discharging patients to social care was a “massive own goal”.
Ambulances had become “wards on wheels” while patients waited to get hospital treatment, Boyle said, adding that those most at risk “are the people that the ambulance can’t go to because it’s stuck outside the emergency department”.
He said there were lots of causes of the approximately 900 excess deaths estimated in England last week “but we think problems with urgent and emergency care are probably contributing to about a quarter of this”.
Boyle spoke after hearing one woman describe her mother waiting for an ambulance overnight in agony with a broken hip. Ambulance workers have voted to strike over pay and conditions, saying they are “on their knees” and facing unsafe staffing levels.
He said he had not seen such waits since the 1990s but concerted effort then had succeeded in reversing the problem. “Going back 20 years, we were able as a country to turn this round.” Boyle said.
His comments came as the NHS launched 42 “winter war rooms” across England, designed to use data to respond to pressures on the health system.
When asked about the project, Boyle said it was too early to tell if it was a good idea, adding: “You can paralyse yourself with analysis, it really is actually more simple and about building increased capacity.”
He said the problem was best solved by focusing on hospital discharge and social care. “Fixing this starts at the back door of the hospital and being able to use our beds properly,” he said.
“At the moment, there are 13,000 people waiting in hospitals, about 10% of the bed base, who are waiting to be discharged either to home, with a little bit more support, or to a care facility. And that’s just a massive own goal. We just need to reform the interface between acute hospitals and social care.”
The idea of the 42 NHS “traffic control centres” will be to get patients into beds more quickly and manage demand by crunching information on issues such as A&E waiting times, staffing levels, ambulance response times and bed occupancy. Staff will be able to divert ambulances away from full hospitals to ones with capacity.
Prof Stephen Powis, the NHS national medical director for England, said: “These locally delivered control centres are just one part of our wide-ranging preparations for winter but will play a vital role in the sharing and use of vital information to drive smarter decision-making by local NHS teams.”
