You’d be hard pressed to turn on the news or open a newspaper without reading about how our National Health Service is being drastically underfunded, and yet patient numbers are increasing threefold as the pressure overwhelms out of hours services. Just a few weeks ago sat in A&E on a Thursday night, the waiting time was expected to be above four hours before discharge, the infamous four hours being the time jammed down our throats that we can be seen, treated and free to go or admitted. But if you’ve ever taken the time to read memoirs and blogs by Doctor’s and Healthcare Professionals themselves you’ll know the intense pressure they are put under to perform despite increasing managerial interference. And that’s before you get started on the deadlock with Junior Doctor’s and the decrease in nursing staff as they either defect abroad or quit to move into a less stressful career. From even a naïve and distant point of view, the state of the NHS is a worrying concern as the thought of losing it strikes fear deep into the heart. The annual Winter Crisis seems to be the straw that’ll break the camel’s back as patient safety becomes fragile with increasing stories of struggle and even death from missed diagnoses.
As you’d expect a ripple effect occurs, wards become crowded, A&E departments have nowhere to move patients, ambulances are sat outdoors waiting for hours before they can admit patients and vulnerable people are left waiting at home before they can be seen. Routine operations are cancelled enabling a backlog, agency staff are shifted in to cover sickness meaning a lack of specialist staff on medical wards and the longer a person is left in hospital because of a lack of social care, the more susceptible they are to become infected with secondary diseases. Some hospitals have to send patients miles out of the way in the hope they can be seen to earlier as healthcare professionals struggle to survive on basic wages with stories revealing some are relying on food banks to feed themselves and their family. What could it take to make the NHS crumble so far as to how it has?
Unfortunately, I have seen first-hand the struggle of dealing with a loved one diagnosed with influenza alongside having a progressive and far deteriorated lung disease. We were lucky in many aspects as the GP went out of his way to see and follow Dad whilst he was at home, and when the worry began of potential septicaemia or internal bleeding, a community paramedic sat with us for two hours before an ambulance could transport him to hospital. For hours he was placed in a Resuscitation room, hooked up to every machine imaginable whilst Doctor’s poked and prodded. When flu was confirmed he was transferred to a side room on the Emergency Management Ward and stayed here for nearly two weeks as a High Dependency Nurse regularly dropped in to check on the specialist equipment that was helping his lungs cope. Intubation was ruled out because it was deemed too risky considering how little capacity he had left to breathe for himself, and instead I visited every day as if working a full-time job to help wash, feed and entertain him as he sat isolated in the side room.
We were also unlucky in many aspects in that the nurses on hand had little to no knowledge of his lung disease or how to manage patients with high needs of oxygen. Many times, he struggled trying to visit the toilet when I wasn’t present because Nurses ignored the marks on his notes for needing his oxygen to be drastically increased to help him cope without panicking or having an anxiety attack. The most worrying and upsetting experience of all came when an agency nurse tried to transfer him to another ward, without the assistance of a Porter and by trying to remove all of his oxygen so she could cover his mouth with a protective mask. This was late at night, after we had left and before we could return. Eventually having gone up a floor and finding the supposed vacant bed was empty, he was transferred back to the original side room and left on his own with no oxygen and his nurse call out of reach. Thankfully, she re-entered the room after some minutes and plugged in her common sense to calm him after he struggled severely with a lack of oxygen. Just to be clear, this was a frail vulnerable man who had lost over half of his lung capacity and was a severe danger for fatality with how his body was struggling to stave off infection. Needless to say, all hell broke loose when my Mum found out the following morning what had happened.
As the Winter Crisis began to increase towards the end of 2017, the British Lung Foundation published a report called Out in the Cold. This stated clear facts that despite evidence of respiratory complications fuelling the NHS fallout through Winter, over the past decade little had been done to better adapt or cope with the extensive requirements of lung disease patients. They advised for better prevention, improve community care both before and after hospital admissions, and to overall recognise how critical lung disease is yet how underfunded and ignored it is. Flu is causing severe complications in people who are struggling with air pollution, who already have a diagnosed lung disease or those who are reaping the rewards of having smoked long-term causing irreparable damage to their pulmonary system making them vulnerable to flu and infection.
My worry is that little has been done despite the clear evidence that has been produced, that people of all ages are struggling as a lack of specialism exists within community hospitals regarding how to manage oxygen needs, that patients are being left isolated and forgotten about once discharged and that more and more people are needlessly deteriorating at a quicker rate because there are little prevention strategies in place to help them manage through the distinct vulnerable months. I have seen first-hand from an outsider’s point of view, what it’s like to be a carer doing their best to help their loved one get the attention and care they need, only to be left disappointing and frustrated when they are essentially abandoned in their time of need. The Winter Crisis or NHS system isn’t an overnight fix, it needs time and it needs patience, but most of all it needs open minds from healthcare professionals drowning in their workplace on what they need to improve the care they can give.