The NHS crisis in England – how it compares to the past

Patients died in the corridors and hospital staff at breaking point – the pressure on hospitals in England made headlines across the country.

The situation was so dire that 68 leading A&E doctors wrote to the Prime Minister to address their concerns.

But this was in the winter of 2017/18, not 2021/22.

read more – See first pictures of Solihull Nightingale becoming a COVID Hub

It was the last bad flu season when, at one point, more than 300 people were dying a day from that virus.

And it wasn’t even a one-off. In January 2016, hospitals were canceling routine operations, asking patients to stay away from A&E, and setting up emergency treatment areas outside some units – just as they are today.

The last decade has been a tale of long waits and dwindling performances, bbc report,

So is the NHS crisis facing our country now, in times of COVID, really worse than it was before?

A&E wait time

A&E wait is a good barometer for how NHS pressures have changed in recent years.

According to data from NHS England, the proportion of patients waiting less than four hours – a key metric in measuring NHS effectiveness – has gradually decreased.

In November 2010, England’s figure sat comfortably on the target of 95 per cent. It was falling below 75 per cent in November 2021.

It’s a similar story elsewhere in the UK – in Wales and Northern Ireland the performance is even worse.

This should not come as a surprise, as NHS spending has been squeezed.

NHS spending

Between 2010 and 2019, the amount spent on health was significantly less than what has traditionally been given since the birth of the NHS, making it difficult to meet the needs of an aging population.

During that period, the Conservatives have remained in power – albeit with Lib Dems for the first five years.

Figures for the average annual growth in government spending above inflation put the period between 1949 and 1979 slightly below the 70-year average (somewhere between three and four percent).

It fell slightly under the Tory government between 1979 and 1997.

It was above average between 1997 and 2010 under Labor, then fell to about one percent during the Conservative/Lib Dem coalition, before rising slightly – between one and two percent – ​​under the current government, as of 2019.

But it is worth noting, in its 2010 and 2015 election manifestos, that Labor was not proposing any higher increases in spending.

The 2008 financial crash meant that all the main political parties had signed on to the idea that spending would have to be curtailed.

This parliament has seen a change – the annual increase is now planned to be closer to 4 per cent and will be higher once the pandemic spending is taken into account.

NHS workforce

But in the 2010s we have fewer doctors and nurses per capita of population than our Western European neighbors.

When comparing the number of practicing nurses per 1,000 people, the latest data puts the UK above Italy – 8.4 compared to 6.7 – but below France (11.1) and Germany (13.9).

For doctors, there were three in the UK, 3.4 in France, four in Italy and 4.5 in Germany.

omicron

The turn of the year is always the hardest time. And with A&E’s latest data covering only November, we need to look elsewhere to decide just how dangerous the current pressures driven by the Omicron version are.

There have been reports of hospitals declaring serious incidents since Christmas. One of England’s seven hospital trusts was in this position at one time on Wednesday evening.

However, it is very difficult to judge what these announcements tell us.

They are not usually made public and are instead meant to alert local health systems that a service is in need of assistance. We have nothing to compare them to.

ambulance delay

If we look at ambulances delaying dropping off patients at A&E – this data is available in England as of last weekend – we can see that the current difficulties are worse than the previous winter before the pandemic hit.

Ambulances queue up outside Queen Elizabeth Hospital, Birmingham – photo taken and tweeted by Dr Puneeth Kempegowda

NHS figures for 2019/20 show the percentage of ambulance arrivals in England waiting more than 30 minutes to hand over patients to A&E staff.

In 2019/20, the numbers fluctuated by about 15 percent. In 2021/22, the December figure was between 20 and 25 percent, fell below 15 percent over Christmas week, and rose to above 20 percent in January.

But it is also fair to say that this does not represent the downfall of the NHS, despite all the headlines.

The truth is that healthcare will not collapse suddenly. Instead, what is happening is that care is slowly deteriorating.

present situation

Heart attack patients are waiting longer for ambulances, more elderly patients are spending the night on a trolley at A&E and an increasing number of people are waiting for hip and knee replacements.

Of course, the challenges are different from those of winter past. After all it is an epidemic.

One woman got Pfizer-BioNtech Kovid Vaccine
One woman got Pfizer-BioNtech Kovid Vaccine

While a massive vaccination campaign is underway, the level of staff absenteeism from COVID is bringing another added complication – it’s almost twice what you’d expect – and explains why the military had to bring in.

Hospitals have also had to completely reconfigure their wards to create COVID and non-COVID zones.

And coming in huge numbers is a problem. Traditionally there are about 1,000 admissions a day for all types of respiratory infections in winter.

Currently the NHS alone is looking at more than double that for Covid – although a portion is believed to be people who are ill from something else, such as a broken arm, stroke and cancer for example, and are well anyway. can come from.

But even if you exempt these patients, you are still above the 1,000 limit.

Elsewhere, however, less pressure has helped the NHS. The flu is at rock-bottom level. Less than 50 patients of this virus are in hospital in England.

So, what can we conclude? The challenges are certainly worse and it is turning into poor quality services.

But this isn’t the first year care has been compromised.

What matters now is when the COVID infection is at its peak – that will determine how bad this winter will be.

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