Thread by @danielgoyal

Why is the NHS past breaking point?

I wish I could bring you good news. I wish I could tell you as the peak of Omicron passes🤞we are regaining the capacity to treat the millions waiting for urgent and routine care. But, honestly, it has never been as bad as this.

Why?
🧵

There are streams of doctors and nurses raising the alarm...it is simply unsafe and patients are suffering. And yes, patients are undoubtably dying due to the level of healthcare rationing currently in place.

https://twitter.com/RCollEM/status/1493639396159111171?s=20&t=hicVQH-tcv-noj8g3cEIFw

It is a sign of failure when we can't provide routine care.

Currently waiting lists are at 6.5m for "routine" care.

It is a whole other kind of failure when we can't provide semi-urgent care.

Every month thousands more cancer patients join the queue waiting 2 months to start their cancer treatment!

You have cancer...you know it can spread...but you have to wait two months!

But now we enter a whole level of failure...the inability to provide Urgent and EMERGENCY CARE...

https://twitter.com/RCEMpresident/status/1493646894299557895?s=20&t=hicVQH-tcv-noj8g3cEIFw

The effects are very real.
The number of people dying in their own home has shot up through 2020 and 2021 (data pending for 2022)

And most of the excess death is in UNDER 65 yrs of age

I'm sorry, it is scary. It is dangerous for the public. But meanwhile this government just keeps spinning the truth and focussing on those targets that will get them votes. As an ED Doc puts it...

https://twitter.com/EmergencyBod/status/1494399343482257411?s=20&t=hicVQH-tcv-noj8g3cEIFw

But why, when Covid has been 'defanged' should the UK's healthcare system be failing?

1. Covid.
2. The UK Government
3. The lack of engagement from media

1. Covid
We are running on average with a 10% increase in workload from acute Covid. 10% in a system that works with 2-3% margins of activity.
Before this winter, had we hit November with a bed occupancy over 85% (safety level) panic would ensue. Nov 2021 we were already at 94%.

Then Omicron hit, took over 15% of our beds and led to 2k admissions per day. There is still 10% medical beds taken up and still over 1k admissions per day.

But there are the other effects of Covid on healthcare...

We know that following admission to hospital with Covid the use of healthcare increases 3.5 times for the foreseeable future. Similar albeit higher than pneumonia, we expect around 3 yrs of this for each patient.
We have had over 600k Covid admissions!

We know heart disease risk increases dramatically following Covid, more so with severe disease but also with mild disease...

https://twitter.com/Nature/status/1493550624314695685?s=20&t=hicVQH-tcv-noj8g3cEIFw

The rate of mental illness following Covid also dramatically increases...

[note the massive increase in mental health referrals]

https://twitter.com/danielgoyal/status/1494241207668514816?s=20&t=hicVQH-tcv-noj8g3cEIFw

We then have additional unspecified Long Covid cases, the consequences of prolonged lockdowns - delayed diagnoses, deconditioning, loneliness, poverty..., and the other consequences of people being unable to access care - presenting late and being very unwell!

2. This UK Government
Meanwhile we have a government who has demonstrated they will do whatever they can to avoid doing anything to strengthen the NHS. Even during a pandemic.

They shrunk the NHS by 8%. Yes, during a pandemic with an extra 10%+ new patients.
They bypassed GPs, pushing patients to commercial non-clinical providers of Covid tests and trace
They took the money for Covid and gave it to their mates. £36bn to T&T, £0.25bn to GP services.

And now, when we are all screaming that we can't provide basic emergency care to the public, they are talking about investing 'NHS' money in new technologies and 'waiting list initiatives', which they aim to be provided by 'independent sector'.

We, the clinicians are saying the patients need x, and the politicians are yet again (as they did with Covid) overruling us and providing, not 'y', but empty promises that will do absolutely nothing to improve patient care.

Undoubtably, the biggest risk to patient safety just now is This Government, Johnson's Government, a government the Tory party are supporting.

3. Media
And I'm afraid many media outlets are failing to hold them to account! Highest EVER cancer waits, A&E waits, operation waits, resignations, vacancies...and it seems this is not newsworthy to some outlets.

There are solutions. In fact, there are very simple solutions
1. Improve pay and working conditions for frontline staff! A 15% across the board pay rise (junior docs, nurses, porters, secs, PTs...), proper overtime pay, rest rooms, even fecking tea and coffee would be a start.

2. Invest in more beds, not more tech! We need a 10% increase in bed capacity just to "live with Covid"...and if we are to drive waiting lists down, then more.
3. We need to drive down urgent wait times first, then semi-urgent wait times (e.g. cancer), and then elective care.

The focus must be on public safety and harm reduction. As it stands This Government's policies are only going to increase harm to the public. Forcing a very stretched service to drive down election-losing waiting times only further comprises urgent and semi-urgent care.

This Government is failing! They have failed to protect life and livelihood throughout the pandemic, they are again failing now!
I will remind you, the majority of excess deaths are in those under 65yrs! We can't allow incompetence and corruption to destroy any more lives!
END!