As reported in The Guardian Healthcare Network by an anonymous NHS trust chair:
"The past week has been very challenging, and we fear worse is on its way.
No doubt people were trying their best not to be a burden on public services over bank holidays but last Tuesday and particularly Wednesday the floodgates opened. Experienced consultants told me they had never seen anything like it. We stopped all elective surgery indefinitely – save for day surgery – and reallocated consultants who by early evening all looked grey with exhaustion, but exhilarated by a kind of Dunkirk spirit that had spread throughout all staff including porters, cleaners, nurses and junior doctors. We had re-established some modicum of control by 6pm.
We are many beds more than official full capacity, not all of which are covered by winter pressure funding. Four of the extra ones are normally reserved in maternity for morning sickness patients but have gone to medical patients we thought would go home but they deteriorated overnight and stayed over the weekend.
NHS England in its wisdom insists on two and three-hour teleconferences where all trusts download their tales of woe and get asked unhelpful and uninformative questions and are then subjected to some rude and unhelpful instructions of the “keep a lid on it” type. We’re also told we’re lying and not doing enough in not quite so many words.
Senior managers have to be on site seven days a week for these conferences. This is undermining morale big time. We have so far pushed back saying we will only do this if we consider it essential and appropriate.
It feels very, very close to a tipping point and we are not alone.
I’ve cancelled the next board seminar and am sending members round the wards to say thank you and well done to all colleagues with instructions to managers and ward sisters to turn us away if they can’t cope.
Monday morning was calmer but the physical drain on consultants, junior doctors and nurses is evident in drawn faces. Worse, flu is spreading rapidly across wards. If the vaccine isn’t quite the right one, it will get much worse. The next three weeks will be critical. It will get worse before it gets better.
I think describing the current situation as “a humanitarian crisis” is a bit over the top. The bigger question is that the demands of targets on individual trusts are probably – choosing my words carefully – leading to gaming. Equally we are all meant to have abandoned all elective surgery but there are strong suspicions that certain trusts are not following this; still doing certain surgery because they make so much money.
What we are seeing is a breakdown in the trust and cooperation between different parts of the NHS. So we have seen mental health almost withdrawing from the sustainability and transformation plan process. We have major acute hospitals trying to protect their pre-eminent position by being too important/big to work with others. We have clinical commissioning groups in denial about their total absence of any long-term future. We have NHS England shouting down the phone at hard-pressed managers. We have NHS Improvement texting chief executives on Saturday afternoons checking that they are on top of the situation and expecting them to be at work.
Not one of these actions is going to help a hard-pressed consultant with targets – or more critically the patient. Worse than that, the pressure from above is largely political because government ministers and MPs cannot accept the reality of the general slide to a service that doesn’t meet what the public expect."