NHS' hospital crisis: Wiltshire's clinical commissioners warn people to think twice before attending A&E

Written by Tony Millett on .

The Prime Minister is blaming part of the crisis in NHS hospital A&E on GPs who do not open their surgeries 8am-to-8pm 24/7.  Wiltshire's health officials are putting a share of the blame on people who attend A&E when they do not need to.

With national headlines full of the latest grim figures showing how the NHS is being overwhelmed by demand especially in hospital A&E departments, health bosses in Wiltshire have issued a stark warning to members of the public who are misusing emergency NHS services, putting unnecessary pressure on hospitals and putting more seriously ill patients at risk.
According to a statement from the Wiltshire Clinical Commissioning Group (CCG), between 31 December and 8 January just over 5,000 people attended A&E departments at the three acute hospitals that serve Wiltshire - Royal United Hospital, Bath, Great Western Hospital and Salisbury District Hospital. Yet only a third of those people actually needed urgent or emergency treatment.

"Over the last month, people have attended A&E departments with minor ailments which are not serious or life-threatening - these have included coughs, colds and sore throats, toothache, sickness and diarrhoea, excessive alcohol consumption, backache and broken finger nails."  

It is clear, however, that on occasion some of those conditions can herald serious and even life-threatening illness.  People are urged to go first to their GP or to telephone the NHS 111 service.
Tracey CoxTracey CoxTracey Cox, NHS Wiltshire CCG's Acting Accountable Officer, said: “Emergency departments right across the region are extremely busy and people must start taking accountability for their actions and the impact this has on the NHS."
“Our message is very simple: if it is not a serious or life threatening emergency then please do not waste the time of busy hospital teams or 999 services who are there to look after patients who are very sick and who do need immediate medical help."
“Many of the attendances the region’s hospitals are seeing are for common winter illnesses such as bad colds, viruses or stomach bugs which always circulate in the community at this time of year.  These are best looked after at home with over the counter medication, plenty of fluids, rest and recuperation - they certainly do not need a trip to A&E.”
The NHS always sees a rise in emergency admissions to hospital at this time of year, particularly amongst older people, who are much more susceptible to serious illness or injury during the cold winter months.  The CCG statement says: "For every inappropriate A&E attendance the attention of hospital staff is pulled away from caring for those who really do need immediate and potentially lifesaving help."

The CCG's statement addresses one of the causes of the present hospital crisis.  The other main cause is the increasing number of those who attend A&E and who then need to be admitted to a hospital bed for treatment.  That points to the overall shortage of hospital beds in many parts of the country - including the wider Swindon area.

Weeks before winter started, GWH has been operating at bed capacity of over one hundred per cent - that means extra beds have been commissioned to cope with the number of patients needed treatment. The safest and most efficient level for bed occupancy is put at 85 per cent.  

This week the RUH in Bath has had to shut a maternity ward used by women having a low-risk pregnancy.  For two weeks it will be used by medical patients instead - due to "unprecedented bed pressures across the health community."

French Health Minister Marisol Touraine speaking to journalistsFrench Health Minister Marisol Touraine speaking to journalistsApart from winter weather, there are other dangers lying in wait for the NHS.  Across the Channel they are in the midst of a 'flu epidemic with 257,000 new cases of 'la grippe' reported last week.  The French health minister, Marisol Touraine, has held crisis meetings and says the epidemic has come earlier than usual, is intense and warned that this year's death toll from influenza may be 'heavy'.  

Some commentators in the French media are saying that her response to 'la grippe' will damage her political career.  People arriving in London from France on Friday received no information from Public Health England about this epidemic.

At the end of a week of damaging headlines for the government, the Prime Minister has acknowledged that the NHS is 'under pressure'.  But she said this was what usually happens in winter and stressed that the government had provided money to prepare for winter pressures - as it usually does.

This year's figure, she said, was £400 million "to ensure that winter preparedness".  But 'ensure' is the wrong word when the pressures on hospitals have been growing ever since last winter and no one can predict quite a winter will bring - no health service can ensure health care in the face of an unusually prolonged spell of freezing weather and/or a serious flu epidemic - especially if it and social care are underfunded.

Mrs May then attacked those GPs who do not offer appointments 8am-to-8pm 24/7.  The logic of this attack is hard to fathom as many GP practices in England are unable to recruit enough doctors - and that includes the Marlborough Medical Practice and the Pewsey Surgery.  So spreading doctors' appointment time more thinly may not reduce the numbers of patients who do not get appointments when they need them and resort to A&E.

The headlines about emergency care and ambulances do not tell the full story.  At GWH's first board meeting of 2017 it was reported that in November the hospital met the targets for timely 'referral-to-treatment', all the cancer access targets for timely treatment and also the six week diagnostic waiting standard.

Healthcare leaders in B&NES, Swindon and Wiltshire are also backing the national Stay Well This Winter campaign which encourages people to look after themselves well.   The details are at this web address.