If the cause was a plane crash or a natural disaster, the needless deaths of 500 people might be declared a national emergency. Not so with the NHS crisis. At least 511 people died in England last year after ambulances in some cases took up to 15 hours to reach them. More than half of paramedics have seen a patient die due to a delay involving an ambulance, or another part of the care system. Coroners have written to ministers warning of a crisis that is proving deadly. It is compounded by the deaths of patients in ambulances queueing outside emergency departments, and the deaths of people inside A&E departments who are waiting 12 or more hours to be seen.
Rishi Sunak insists his government is working to improve emergency waiting times. The public aren’t convinced. Support for the government’s handling of the NHS crisis in England has reached a new low; only 8% of people think ministers have the right policies for the health service. Although response times for ambulance calls have improved since the winter, when callers waited longer than ever in England for ambulances to arrive, the current response time for a category two call – those for serious conditions, such as heart attacks or stroke – is still 32 minutes, nearly twice the 18-minute target.
Too many ambulances are left queueing up outside hospitals, some for as long as an hour, unable to transfer patients to overcrowded A&E departments. Demoralised paramedics wait in vehicles outside, unable to answer emergency calls. Ambulance response times and A&E delays are two factors in a line of falling dominoes. They reflect the social care crisis. Hospitals struggle to discharge people who are well enough to leave because there are not enough social care beds nearby or home care available, creating further delays in A&E. As of December, one in six hospital beds was occupied by people who were well enough to leave but couldn’t be discharged. That amounts to more than 13,000 patients.
Delays in emergency care are only the tip of the iceberg. Austerity has eroded hospital capacity. Many NHS trusts are struggling to afford necessary equipment, while nurses and doctors are leaving the service in droves. Quite simply, there are not enough hospital beds; the total number of NHS hospital beds in England has more than halved over the past 30 years. This is creating a backlog of delays for elective surgery and consultant-led treatments. Seven million people are now waiting for NHS treatment. Junior doctors’ strikes, planned to begin on Monday, will lead to thousands of operations and appointments being cancelled in England. If they are serious about solving the NHS backlog, ministers should negotiate a pay agreement swiftly.
The longer people go without the care they need, the more ill they become – and the more likely they are to end up in A&E. Over the last seven years, the percentage of patients attending emergency departments with multiple long-term conditions has risen from 10% to 30%. This crisis is the product of successive political decisions to underfund the NHS, which ministers show no sign of rowing back on. Headline figures of NHS funding pale in comparison to the amount that is needed. The government still has not published an NHS workforce plan, and the social care crisis remains unsolved. Rather than fixing these problems, ministers seem to be hoping they are a temporary blip that will go away of their own accord. That is highly unlikely.
