{"id":9509,"date":"2016-08-11T16:42:23","date_gmt":"2016-08-11T15:42:23","guid":{"rendered":"http:\/\/unitelive.org\/?p=9509"},"modified":"2016-08-11T16:42:23","modified_gmt":"2016-08-11T15:42:23","slug":"an-impossible-job","status":"publish","type":"post","link":"https:\/\/unitelive.test.igniteamt.com\/?p=9509","title":{"rendered":"An impossible job"},"content":{"rendered":"
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After being pummelled by years of a twin crisis in funding and recruitment, access to NHS care is now dangerously out of reach for patients up and down the country.<\/p>\n

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The Royal College of Emergency Medicine has warned that patients\u00e2\u20ac\u2122 lives are at risk if urgent action isn\u00e2\u20ac\u2122t taken to address the shortage of emergency doctors.<\/p>\n

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The warning came as a United Lincolnshire hospitals NHS trust (ULHT) is considering taking the unprecedented decision to temporarily shut an A&E it runs at night because there are simply not enough doctors on hand.<\/p>\n

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\u00e2\u20ac\u015bWe haven\u00e2\u20ac\u2122t made a final decision yet, and we hope to avoid this, but the reality is we will need to temporarily reduce the opening hours of A&E at Grantham,\u00e2\u20ac\u0165 ULHT medical director Dr Suneil Kapadia told the Guardian<\/a>. \u00e2\u20ac\u015bThe quality and safety of patient care is the trust\u00e2\u20ac\u2122s number one priority and we haven\u00e2\u20ac\u2122t rested on our laurels.<\/p>\n

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\u00e2\u20ac\u015bWe have tried to recruit in the UK and internationally, and we have offered premium rates to attract agency doctors whilst investing \u00c2\u01414m in urgent care services. Despite this, we have reached crisis point.\u00e2\u20ac\u0165<\/p>\n

 <\/p>\n

In response to the potential decision to reduce opening hours at Grantham A&E, Royal College of Emergency Medicine president Dr Clifford Mann said that in under-resourced locations, the \u00e2\u20ac\u015bgreat efforts made by doctors and nurses to help patients\u00e2\u20ac\u0165 is often \u00e2\u20ac\u015bnot sustainable\u00e2\u20ac\u0165.<\/p>\n

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\u00e2\u20ac\u015bAs well as potentially putting patient safety at risk, placing an ever increasing workload on overstretched staff can create a vicious circle in retention and recruitment with many overworked trainees simply choosing to leave the country or indeed the specialty altogether,\u00e2\u20ac\u0165 he said.<\/p>\n

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\u00e2\u20ac\u015bThe wider picture is there is a real crisis in emergency medicine as our workforce numbers are not growing fast enough to keep pace with rising numbers of patients attending A&E Departments.\u00e2\u20ac\u0165<\/p>\n

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‘It all stacks up’<\/strong><\/em><\/p>\n

Unite national officer for health Sarah Carpenter noted that there\u00e2\u20ac\u2122s a staffing problem right across the entire NHS.<\/p>\n

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\u00e2\u20ac\u015bThere\u00e2\u20ac\u2122s a serious supply problem with GPs, for example,\u00e2\u20ac\u0165 she said. \u00e2\u20ac\u015bAnd since there\u00e2\u20ac\u2122s not enough GPs, people have no other option but to turn up at A&E. And then the A&Es can\u00e2\u20ac\u2122t cope. It\u00e2\u20ac\u2122s not the fault of individual trusts and how they manage; it\u00e2\u20ac\u2122s the demand in a particular area.<\/p>\n

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\u00e2\u20ac\u015bAnd then the minute you try to get other professionals to fill the gaps \u00e2\u20ac\u201c there are things that can be done with specialist nurses or with physios or other medical professions \u00e2\u20ac\u201c you find that they too are also in shortage. So you just keep moving the problem.\u00e2\u20ac\u0165<\/p>\n

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\u00e2\u20ac\u015bOn one the other end, there are porters who are being expected to cover nursing duties because there\u00e2\u20ac\u2122s a shortage of nurses,\u00e2\u20ac\u0165 she explained. \u00e2\u20ac\u015bSo everything shifts up and stacks up and it affects all grades in the NHS.\u00e2\u20ac\u0165<\/p>\n

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Indeed, in a recent Care Quality Commission report<\/a> which looked into the failings at North Middlesex hospital, the NHS care regulator found that its A&E was so understaffed and busy that untrained receptionists were being asked to judge which patients needed to be seen first.<\/p>\n

 <\/p>\n

‘How would you manage?’<\/strong><\/em><\/p>\n

Carpenter highlighted that \u00e2\u20ac\u015bvery difficult decisions have to be made locally\u00e2\u20ac\u0165 and the ultimate culprit is inadequate funding.<\/p>\n

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This was nowhere made more apparent than in Merseyside, where the St Helens clinical commissioning group has for the first time proposed, among other ideas, to suspend all non-urgent treatment for four months in an attempt to tackle its shortfall in funding.<\/p>\n

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Dr Richard Vautrey, deputy chairman of the British Medical Association\u00e2\u20ac\u2122s GP committee argued that halting non-urgent treatment across-the-board was a very dangerous move and one that showed just how desperately the health service needs greater funding.<\/p>\n

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\u00e2\u20ac\u015bWhat apparently may not be urgent at first presentation and is therefore not referred could turn out to be very serious in the long term,\u00e2\u20ac\u0165 he said. \u00e2\u20ac\u015bMany cases of cancer are subsequently diagnosed following routine referrals of patients who have undifferentiated symptoms early on in their illness.\u00e2\u20ac\u0165<\/p>\n

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St Helens CCG chair Geoffrey Appleton explained their decision to put a series of proposals up for public consultation<\/a> to determine which services will be suspended, withdrawn or reduced.<\/p>\n

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\u00e2\u20ac\u015bTo explain it in simple terms, imagine our NHS budget is your household budget and every year the cost of living goes up but your salary doesn\u00e2\u20ac\u2122t increase,\u00e2\u20ac\u0165 he said. \u00e2\u20ac\u015bThe result is money becomes tighter and tighter. Now imagine another relative comes to live with you and because of their health needs are unable to work and cannot contribute financially. How would you manage?\u00e2\u20ac\u0165<\/p>\n

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Vice president of the Royal College of Surgeons Stephen Cannon believes<\/a> that what\u00e2\u20ac\u2122s happening at St Helens is \u00e2\u20ac\u015bnot just a one-off; this is a growing problem across the NHS\u00e2\u20ac\u0165 and Carpenter agrees.<\/p>\n

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\u00e2\u20ac\u015bI think this problem is definitely spreading,\u00e2\u20ac\u0165 she said.<\/p>\n

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The blame, Carpenter argues, should fall squarely on the shoulders of both funding arrangements as well as the structural problems that are plaguing the NHS.<\/p>\n

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\u00e2\u20ac\u015bThe constant change in structure is a huge problem,\u00e2\u20ac\u0165 she explained. \u00e2\u20ac\u015bCCGs themselves potentially become part of the problem because they exist to commission out services which don\u00e2\u20ac\u2122t do anything but cost a lot of money.\u00e2\u20ac\u0165<\/p>\n

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Change course now call<\/strong><\/em><\/p>\n

Carpenter fears that the government\u00e2\u20ac\u2122s chronic underfunding of the NHS is a deliberate move.<\/p>\n

 <\/p>\n

\u00e2\u20ac\u015bYou could view all of this as a bigger attempt on the part of the government to say, well the health service looks like it\u00e2\u20ac\u2122s on its knees, therefore we should privatise it,\u00e2\u20ac\u0165 she explained. \u00e2\u20ac\u015bTheir policy will be, \u00e2\u20ac\u0098How far can we go to destroy the NHS so that privatisation can go through smoothly?\u00e2\u20ac\u2122 \u00e2\u20ac\u201c they think, ‘well, no one will object to a rundown service being taken over’.\u00e2\u20ac\u0165<\/p>\n

 <\/p>\n

Carpenter said that Unite is calling on the government to change course immediately to save an NHS that desperately needs support.<\/p>\n

 <\/p>\n

\u00e2\u20ac\u015bOur message is this — invest properly in a national health service. Stop believing that it can be done better by private companies.\u00e2\u20ac\u0165<\/p>\n

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She argued, too, that the NHS staff who work incredibly hard to keep the service running should be treated with respect, instead of with the derision that was most recently exemplified during the junior doctors’ dispute.<\/p>\n

 <\/p>\n

\u00e2\u20ac\u015bTrust the people who are currently running the service to deliver that service and give them the proper tools to do that,” Carpenter urged the government. “Stop blaming them every time that there\u00e2\u20ac\u2122s a problem. Acknowledge that those who are running the service are trying their best to do an impossible job.\u00e2\u20ac\u0165<\/p>\n","protected":false},"excerpt":{"rendered":"

After being pummelled by years of a twin crisis in funding and recruitment, access to NHS care is now dangerously out of reach for patients up and down the country.   The Royal College of Emergency Medicine has warned that patients\u00e2\u20ac\u2122 lives are at risk if urgent action isn\u00e2\u20ac\u2122t taken to address the shortage of […]<\/p>\n","protected":false},"author":1,"featured_media":6854,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[17],"tags":[29,81],"wps_subtitle":"Breaking point for NHS amid funding and staffing crisis","_links":{"self":[{"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=\/wp\/v2\/posts\/9509"}],"collection":[{"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9509"}],"version-history":[{"count":1,"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=\/wp\/v2\/posts\/9509\/revisions"}],"predecessor-version":[{"id":9510,"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=\/wp\/v2\/posts\/9509\/revisions\/9510"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=\/wp\/v2\/media\/6854"}],"wp:attachment":[{"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9509"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9509"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/unitelive.test.igniteamt.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9509"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}