The doctor’s union BMA Cymru Wales has released the findings of their NHS pressures portal, a place where doctors from across Wales have shared accounts of the state of their working conditions and the pressures they face on a daily basis. BMA Cymru will present the accounts to Welsh Government and NHS Employers.
From treating patients in cupboards and on chairs, working 12 hour shifts without breaks, and understaffing, doctors have laid bare their experiences to highlight the risks to patient and staff safety.
One account from the portal shared by a consultant specialising in geriatric care said they hadn’t treated a patient in a bed during their last ten shifts. Doctors explained they are often forced to use cupboards or borrow rooms to treat due to a lack of space.
Other concerns included patients waiting up to 14 hours in A&E being the new normal, patients needing cardiac monitors going unmonitored due to lack of space and patients being treated in the back of ambulances.
BMA Cymru Wales Chair Dr Iona Collins said:
"We’ve heard from doctors from every health board in Wales in both primary and secondary care with each account sharing a similar dismal picture of chronic understaffing, underfunding, and inadequate facilities – what we have here is a demoralised workforce.
"First and foremost, doctors are concerned for the safety of their patients. The ever-increasing delays on all fronts are resulting in patients who could have been treated in a planned manner are now turning up in crisis instead.
"The result is that emergency treatment has to be provided sometimes in the middle of the night with less support, instead of at safer times of the day. We already know that emergency operations, for example, are more complicated and are associated with more complications in comparison with planned operations.
"It stands to reason that when people wait longer and longer, with their conditions deteriorating all the while, we end up performing emergency treatments instead of planned treatments. This is obviously bad for the patient, but it's also bad for our economy, since complications are expensive to treat.
"The inability to manage the flow of patients through the whole Health and Care system is causing serious problems at every stage.
"One doctor told us that at their hospital up to 45% of patients on wards were well enough to be discharged but, due to a lack of social care provision, were left in acute medical hospital beds instead of rehabilitating at home. It’s the same across the whole country.
"The findings of our Pressures Portal paint a grim picture of our health service and we can’t continue to expect patients to be treated in these conditions. Welsh Government must listen to these numerous and basic safety concerns of the frontline workforce."
Doctors contributing to the portal highlighted feelings of low morale, extreme stress, often working long hours with no breaks or even time to rehydrate.
Rising complaints from patients also featured, due to unsafe staffing levels leading to poorer levels of care.
BMA Cymru Wales is calling on the Welsh Government to:
- Work with frontline staff to develop local plans to tackle the backlog – members are still reporting a worrying lack of engagement
- Work in social partnership to produce an all-Wales workforce strategy that tackles both the long-term sustainability and the urgent retention and welfare challenges facing the NHS Wales workforce
- Improve and expand social care provision to create a more coordinated service between the NHS, and care in the community to meet the needs of patients
- Swiftly introduce incentives for existing doctors to remain in the health service. This includes implementing the retire and return principles, to mitigate the impact of punitive pension taxation policies as well as ensuring less than full time trainees benefit from pay systems equivalent to full time colleagues
- Improve staff wellbeing, engagement and morale by helping to implement the fatigue and facilities charter across Wales in full
Notes to editors
Please find further accounts shared with us from doctors in Wales via the BMA Cymru NHS Pressures Portal.
Dr Georgina Budd, Co-chair BMA’s Welsh Junior Doctor Committee, and a GP, added: "We're not at breaking point, we have broken. We all have horror stories about colleagues and patients who have been let down. There's a hopelessness."
Dr Stephen Kelly, Chair BMA’s Welsh Consultants Committee, said: "I absolutely hate doing on-call work; the working conditions are awful. There is no incentive to do additional work and it is neither safe nor sustainable."
Dr Nicky Leopold, a Geriatrician in Swansea, said: "During my last ten on-call shifts I have not seen one patient in a bed or even a trolley for assessment. We are using cupboards, borrowing rooms in outpatients and I have had patients with drips laying on the floor.
"Often patients in the waiting rooms have not even been given food and drink. We recognise emergencies such as hyperkalaemia (higher than normal potassium levels in the blood) which is life-threatening but we’re unable to even give immediate life-preserving treatment due to lack of space and staff."