You will have no doubt heard about the pressures on the NHS just now. It is true, we are worried. We have begun this Winter under considerable strain - more than usual. And, I won't lie, we expect things to get worse.
1/15 #NHS
We have little capacity - both emotional or beds. We are short staffed, and on top of all this we have a pandemic to deal with.
I understand you too may be running out of capacity... to face even more calamity after a calamitous 20 months. You too must be worried.
2/15
Firstly, can I say, we are still here. We get up in the morning (or night) and come to work. We donn our PPE, roll up our sleeves and face the avalanche of patients, requests, relatives, battle-hardened colleagues, and a pathogen that we have lost many colleagues to.
3/15
But we are still here.
And if you arrive here at our door, we will do our very best to protect you and help you return to the life you enjoy, regardless of who you are or how much you earn.
But I will not lie to you. We can only do our best with what we have available.
4/15
What we have available just now is simply not enough. Not enough to provide the quality of care we are trained to deliver. Not enough to deliver the quality of care you deserve or have paid for.
5/15
You may have heard from some commentators (all outside looking in) that there are still enough beds for the 1000 additional COVID patients we must admit and treat everyday. You may even have heard the problem is the management of the NHS not it's resources.
6/15
These part-truths are somewhat more bearable to hear than the actual truth..
When resources are tight we must make difficult choices. When we have only two or three beds available on each ward, we have to prioritise who gets them. This happens over 85% capacity. Now at 93%.
7/15
We always decide based on clinical need, not on who can afford it or who knows who. It is the simplest part of my job in that way: the medicine decides, not the managers. But, how unwell someone has to be to gain entry to the current, rationed service is getting too grave
8/15
No doubt you will also have heard about the NHS being sold off to private companies. That, there is a concerted effort to defund the NHS and reduce the quality of care provided....to make you unhappy with the service and embrace a newer, profitable service.
9/15
I do agree with the choice: private versus public. There are arguments for each. But at the moment, the NHS is all we have. Private healthcare could not cope with one-tenth of the demands just now. And, IMO, failing to invest in our health service now, is unforgivable.
10/15
Today the budget will announce a nearly £6bn investment in the NHS. Please look at the details. It is not to benefit those sicker patients, who need more nurses, more beds, more GPs, more access. I am quite sure it won't even help reduce the waiting lists.
11/15
Over half the money will go to industry for new technologies and new diagnostic machines, which while potentially useful, will not make our health service safer or actual treatments more accessible.
I fear we may be heading toward a repeat of the Test and Trace failure...
12/15
...£37billion spent outside the NHS, to provide a service that failed to provide any significant benefit for the public. A lot of public money, your money, spent without a coherent, clinically justified plan.
The entire primary care budget for England is £12bn.
13/15
Our focus must be on the national crisis. Bed capacity is lower than before the pandemic started, there are less frontline staff, less GPs and diminishing investment. Private sector isn't ready and we need a functioning health service.
14/15
So, what to do?
Make some noise!
On any platform.
Demand your right to have your money spent directly to secure access to basic healthcare.
Demand better focus from our representatives.
This is my noise.
Simply put, WE NEED YOUR HELP...so we can keep helping you.
Firstly, don't be fooled. Investment into waiting lists are unavoidable. The restricted access during the pandemic mean a catch-up initiative was always going to be needed.
The first question: would more decisive leadership have led to less restriction to care and less backlog?
The second: how much have the years of underinvestment in the NHS worsened the problem?
The waiting lists have been growing massively under this government prior to COVID.
Clinical care for COVID-19 in the UK: shortcomings and lessons to be learned.
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My view on what next...
Here, I summarise the threads I have written over the last couple of months.
It will tell part of the story of the UK's national response from a clinical perspective.
I have attached the previous threads only for those who wish more detail.
There are several critical failures in the clinical pandemic response, including: 1. The Herd Immunity Strategy 2. Reducing basic healthcare capacity 3. Bypassing primary care triage for non-clinical Covid triage 4. No Covid follow-up service
Ideology has no place in a national crisis. You must do the first part of your job: protect the people. The second, promoting growth can only be done after you have been successful in the first - living being a pre-requisite for success.
I fear I am not getting through to you. Another way then. When the dust settles, and the true endemic level of SARS-CoV-2 is known, there will be a tally. There will be a count - with all the data, across all the domains that the many observers have collected.
The count will not be in your favour. In fact, when historians put pen to paper, the Johnson-era - on your current trajectory - will be remembered as a cautionary tale, a bookmark in history to teach those that come after you a simple fact: decisions are rarely binary.