Emergency departments ‘on course for worst winter on record’, says BMA

Pressure levels in the NHS this winter are ‘likely to exceed’ those from last year if current trends continue, the British Medical Association (BMA) has warned.

According to its analysis, up to 10,000 extra hospital beds will be needed to care for patients safely this winter.

The number of patients waiting for a hospital bed during the winter months spanning January, February and March could rise from 226,000 to 238,000, the doctors’ union warned.

To bring bed occupancy down to a safe limit, the BMA said the NHS will need to continue using 5,000 escalation beds this winter – opened at the peak of the winter crisis last year – and  an extra 5,000 general and acute beds.

The number of people admitted to major A&E departments in England is projected climb from last year’s total of 3,709,000 to reach 3,723,000 this winter.

The percentage of patients being seen, admitted or discharged within four hours of visiting emergency departments is expected to reach ‘record lows’ at between 84.3% and 82.5% – below the health services’ 92% target.

Despite evidence that NHS leaders are working hard to avoid a winter crisis this year, ‘at this stage it seems extremely hard to envision how that can be avoided’, the BMA said, as trusts’ abilities to manage pressures during the coldest months have diminished year-on-year, it warned.

Further, the £240m of extra funding allocated to the social are sector to help ease pressure on the health service this winter ‘will not dramatically alter the overall picture’, the association warned.

Cancellations for scheduled operations are also likely to be widespread, it said.

Dr Rob Harwood, BMA consultant committee chair, commented: ‘This winter could be the worst on record for frontline emergency care departments.

‘A key part of this problem is the lack of available beds within the NHS system. Last winter saw incredibly high levels of bed occupancy, well above recommended limits, and despite thousands of escalation beds being put into action temporarily.

At this level patients will struggle to get the attention and care they need. The uncertainty being caused by Brexit, especially the future of thousands of EU doctors working in the NHS, is only exacerbating concerns about the level of care the NHS can deliver.

‘The government must address these endemic resource issues that are denying patients the level of care they deserve.’

David Hare, chief executive of the Independent Healthcare Providers Network, said: ‘As the BMA’s analysis rightly shows, it’s too often vital elective procedures that are the first to be cut when resources are tight – with tens of thousands of planned operations cancelled last year causing pain and distress for many elderly and vulnerable patients.

‘Given the desperate shortage of beds in the NHS, it’s vital that the significant capacity in the independent sector, including in diagnostics, cancer and other step down care, is swiftly utilised by local areas this winter to ensure patients are not forced to wait unnecessarily long for care, with a clear commitment in forthcoming NHS long-term plan to improving patients access to vital treatment.’