Responding to the latest NHS data for England on waiting lists and emergency care1, Dr Simon Walsh, BMA consultants committee deputy chair, said:
“Today’s figures, coming the day after the announcement from the Westminster Government that we’re now having to move to Plan B, underline just how perilous the situation is on the NHS front line right now.
“The record waiting list is now at almost 6 million, and doctors and their colleagues are incredibly concerned for the welfare of their patients who have been waiting months on end for the care they need, with more than 312,000 waiting for longer than a year – 237 times the number in October 2019. Doctors are continuing to do their absolute best – evidenced in the proportion of patients being seen within 18 weeks increasing – but they are looking with immense trepidation at the insurmountable task in the coming weeks, months and years ahead.
“In emergency departments this winter, the problems are dire. Today’s data shows that, in November, we had a record high number of patients waiting longer than 12 hours on trolleys. It’s clear that hospitals simply do not have the capacity to cope, with problems discharging patients and moving people to wards all having a knock-on effect that ultimately leads to these delays in emergency departments and indeed ambulance services.
“We know this is a huge problem for our members, with three-quarters (75%) of doctors with relevant experience telling a recent survey2 that discharging patients, including to adult social care, has become more difficult in the last year – and more than 8 in 10 saying they are experiencing more delays to admission compared to one year ago3.
“This is even before we consider the impact of a potential further spike in Covid-related hospitalisations in the coming weeks.
“This winter is likely to be the most difficult any of us working on the frontline have ever faced – and we are very worried about the impact on patients. Eight in 10 doctors in our survey said they were more concerned than a year ago that patients would come to harm because of delays in admitting them to hospital4, while a similar proportion said they were not confident about their department’s ability to manage demand this winter5. Around 8 in 10 also said they were anxious at the prospect of work in the coming weeks and months6.
We urgently need to see how the Government plans to address the backlog and support staff both this winter and in the longer-term. With an estimated 100,000 vacancies in the NHS in England, and England being short of approximately 50,000 doctors - when compared to the average doctor-to-patient ratio of our most comparable EU neighbours7 - workforce retention will be absolutely crucial to this. Priority must be given to staff safety and wellbeing, including by taking a zero-tolerance approach to violence and abuse, and assurances over access to appropriate levels of PPE. Many staff have worked non-stop over the last 20 months and are exhausted and close to burnout, meanwhile punitive pension taxation rules disincentivise senior doctors from taking on work and providing care, or in the worst cases lead to them retiring early. We simply cannot afford to lose our most expert doctors at such a critical time.
“And while yesterday’s announcement on further measures to stem the spread of Covid-19 in the face of the highly-transmissable Omicron variant were a necessary step, everyone can do their bit to help the NHS and look after themselves and one another by being as cautious as possible this festive season, and crucially, by taking up the offer of a vaccine or booster when it comes their way.”
Notes to editors
The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.
- Consultant-led Referral to Treatment Waiting Times Data 2021-22; A&E Attendances and Emergency Admissions 2021-22.
- 2,424 doctors and medical students responded to a survey between November 24 and 26. When asked “Compared to one year ago, how if at all has your experience of discharging patients (including to adult social care) changed?”, of the 1,142 respondents who said this question was relevant, 75.2% (859) said they had experienced more delays to discharge, 21.2% (243) said they had experienced about the same, and 3.5% (40) said they had experienced fewer.
- In the survey, when asked, “compared to one year ago, how if at all has your experience of admitting patients to hospital changed?”, of the 1,694 respondents who said the question was relevant 83.5% (1,415) said they had experienced more delays to admission, 15.2% (257) said they had experienced about the same and 1.3% (22) said they had experienced fewer.
- When asked, “Compared to one year ago, to what extent are you concerned that patients may suffer avoidable harm to their health from delayed admission or arrival at hospital?”, of the 2,138 who answered, 80% (1,712) said they were more concerned, 12.5% (267) said they were about the same and 1% (21) said they were less concerned. 6.5% said they didn’t know or it wasn’t relevant.
- When asked “How confident are you about your department / practice's ability to manage demand from patients during the approaching winter season?”, of the 2,123 who answered, 40.3% (856) said they were not at all confident, 37.5% (796) said they were not very confident, 17.9% (380) said they were somewhat confident 2.4% (51) said they were very confident and 1.9% (40) said they didn’t know.
- When asked “How anxious or enthused do you personally feel about working during the forthcoming Winter months?”, of the 2,124 who answered, 36,4% (774) said they were extremely anxious, 42% (891) said quite anxious, 18.2% (386) said neither anxious or enthused, 2.1% (44) said quite enthused 0.6% (12) said extremely enthused and 0.8% (17) said they didn’t know.
- To raise our doctor to population ratio to 3.7 doctors per 1,000 people – simply putting us on equivalent standing with today’s OECD EU average - would require a full-time equivalent (FTE) addition of approximately 50,000 doctors. Read more here.