A bleak future for the NHS. Royal College of Physicians call for action

The Health Secretary Jeremy Hunt, today faces a new and damning report which shows a health service near breaking point. Released by the Royal College of Physicians, ‘Hospitals on the edge? The time for action’ points to a lack of continuity of care and an overstretched workforce.

Staff are also having to sacrifice the time spent with trainees due to the pressure of their clinical work and ‘fragmented team structure’.

The report states that hospital doctors list continuity of care as their greatest concern: a ‘quarter of RCP fellows and members rated their hospital’s ability to deliver continuity of care as poor or very poor’. It is commonplace that patients are moved around the hospital, sometimes several times, and often this means they do not have the same nursing and medical staff looking after them.

One patient tells of an elderly woman who was left in her pyjamas and wheeled to the entrance door to be left there:

“She was waiting for transport but obviously in dire need of care. She wore an incontinence pad that was saturated and the chair was also saturated with urine.”

The patient goes on to ask:

“She was ignored. Was no one responsible for her care?”

The greatest fear for the future of our national health service comes in the dire predictions for the workforce. The reduced hours of junior doctors enforced by the New Deal and the European Working Time Directive means many specialties have moved to shift pattern working. This policy could directly affect continuity of care for patients.

Furthermore the training of the next generation of doctors has been dramatically reduced. Around half of consultants report spending less time with their trainees than three years ago – a damning indictment of the coalition’s attempted reforms.

Further statistic’s signal the huge problem of an overworked workforce which is struggling to recruit for the future:

  • 59% of consultants report working more hours than three years ago.
  • Three quarters of consultants report being under more pressure than three years ago.
  • At emergency medicine and general medicine there is a catastrophic lack of applicants, with only 0.8% for every specialty training year 4 (ST4) post in 2011.
  • Almost 50% of medical registrars reported that they enjoyed their ‘not very much’ or ‘not at all’

It is clear that urgent action is needed to ensure that the NHS is improved for not only its current patients but future generations. There must be greater continuity of care and also the training of doctors must not be jeopardized.

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