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Thursday 4 January 2018

The NHS crisis

The BBC are pushing the story of the NHS winter crisis as a way of continuing their war against the Conservative government. There is little analysis other than that that supports the Labour Party line.

Hence I found this comment by RJ on https://biasedbbc.org/blog/2018/01/03/midweek-open-thread-41/# comments illuminating:

'... The crisis always peaks this week and the reason is very simple.

Before the holidays hospitals empty as many beds as possible to create spare capacity. They also reduce the number of elective admissions so that they can admit all the emergency patients coming in through A&E. In most hospitals this means that over the holiday period they can admit those who need admission, and some who don't.

Hospitals staff the beds with the vital clinical staff, doctors and nurses, but they save money by running with a reduced number of diagnostic staff, e.g. in radiology and the pathology lab. Allowing lots of these members of staff to take the week off also keeps them happy and makes managing them easier. The reduced diagnostic capacity results in a backlog of tests. This in turn keeps the beds occupied because the clinical staff are unwilling to discharge patients without these test results. The hospitals end up being full because the front doors had to be kept open, but the back doors were allowed to shut.

By the 2nd January hospitals have a high percentage of patients waiting to be discharged. This becomes a crisis because hospitals need the beds for the elective admissions scheduled for the week. Bed managers are tearing their hair out trying to get enough patients discharged to allow for the pre-arranged admissions – getting them out of the back doors fast enough to keep up with the flow through the front doors. The resultant hot bedding impacts on the proper cleaning of wards and the inevitable outbreaks of infection reduce capacity and make the crisis worse.

The NHS copes with this every winter (it has unrivaled experience of crisis management), but if you throw in a higher than expected rate of flu the system crashes.

The operational managers will tell you that the answer is to ensure that diagnostics are fully staffed over the holidays – but no one listens to them.

You can add in complications from insufficient Social Care staffing over the holidays to get care packages in place for vulnerable patients, but that's outside the control of the hospitals.'

An impartial news reporting organisation would give voice to facts such as these but the BBC is not an impartial news reporting organisation it is instead little more than the propaganda arm of the Labour Party.

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