Responding to the announcement of the Government’s Urgent and Emergency Care Plan1, published today (Friday), Dr Simon Walsh, BMA consultants committee deputy chair and emergency medicine consultant, said:
“Emergency care is in crisis. This is glaringly obvious to staff, patients, and anyone who reads or watches the news.
“Patients in emergency departments are waiting for hours – and even days – without dignity and in unsuitable spaces for care they so desperately need. We know that this is harmful to patients, leading to avoidable deaths. Meanwhile doctors and their colleagues are burnt out and experiencing moral injury because, despite their best efforts, they are unable to provide this care to the standard that they trained so hard to do.
“This long-promised plan will likely leave doctors working in Emergency Departments and other acute specialties severely underwhelmed.
“The emphasis on preventing the need for patients to visit the ED is of course right, but there seems little to nothing on improving the experience for those who do find themselves there. There is a clear need to increase capacity within acute hospitals to improve patient flow and shorten waits – but the plan does not set out how acute trusts will improve this. In reality, beds need staff, and the lack of any plan to retain doctors and therefore to stop persistent rota gaps is a huge oversight. Keeping valuable staff means improving pay and conditions – otherwise we will continue to lose talented doctors from the NHS.
“On mental health assessment centres, whilst solutions must be found to how to help increasing numbers of people needing emergency mental healthcare, we have concerns about separating out mental and physical healthcare when the two are so linked. Investment in the community is desperately needed.
“Meanwhile, the detail on social care is woefully inadequate. As we – and many of our peers – have consistently said, you cannot fix the front door of the hospital without fixing the back. A lack of social care provision means patients who are ready to be discharged are unable to leave, despite the ambition to reduce length of stay. Good social care services also help prevent people needing to use the NHS in the first place.
“It’s right that there is a focus on reducing 12 hour stays in Emergency Departments, but without clarity on how hospital capacity will be increased this coming winter, staff who are battling against impossible circumstances will not feel assured that this plan will deliver.
“We’ll need to look at this plan in all of its detail – as well as the upcoming spending review and NHS 10 Year Plan - but at first glance, it seems that anyone hoping for a radical plan to fix the crisis engulfing emergency care will be bitterly disappointed.”
Dr Katie Bramall, BMA GP committee England (GPC England) chair, said:
“There is a huge missed opportunity where this announcement mentions patients’ challenges in accessing GP services, but offers no proposals and zero funding to increase GP capacity at all.
“With practices in England providing 50 million patient contacts each and every month, we cannot work any harder – the Government must create greater capacity to better meet patients’ needs. This requires investment to drastically expand GP surgeries to house more GPs providing more appointments.
“The spending review and 10 Year Plan must address this, and properly fund what the population has listed as their number one priority for the NHS and what was promised in Labour’s election manifesto: to ‘bring back the family doctor’. Practices are hanging on by a thread and desperately need a new GP contract to drive this transformation to make a tangible difference to the 1.5 million patients that access NHS GP services each and every day.
“Anyone calling 111 for GP care will appreciate how dangerously stretched GP out of hours services are, with poor computer algorithms and cut-cost alternative staff replacing GPs, where patients may be sent to the wrong setting – at best this can be a waste of time, at worst it carries tragic consequences.
“There is a risk that additional paramedics may resort to calling GPs and asking duty doctors on-call to take decisions outside their remit in order to avoid hospital admissions, when joined up urgent care services are what is needed. There is much focus on the need for integration within the NHS but very little detail on delivering it, including access to social care packages which often delays discharges or fails and leads to patients being readmitted.
“With no apparent extra funding for pressures outside hospitals this winter, we fear we will see further predictable NHS crises dominating the headlines yet again in the months ahead unless we stop making the same mistakes.”
Ends
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.
- Please contact the Department for Health and Social Care for a copy of the plan.