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NHS facing a 'tsunami' of patients in A&E departments, experts warn

Published 27/09/2016

Experts said that the NHS has reached a
Experts said that the NHS has reached a "tipping point"

The NHS is facing a "tsunami" of patients in its A&E departments, experts have said, as health officials faced calls for an increase in the number of hospitals to meet rising demand.

Experts said that the NHS has reached a "tipping point" where it cannot close any more beds.

At a conference on the difficulties facing the urgent and emergency care system in the NHS in England, Dr Chris Moulton, vice president of the Royal College of Emergency Medicine (RCEM), suggested that the country needs at least 20 more hospitals to cope with rising demand.

Meanwhile, NHS England medical director Professor Sir Bruce Keogh highlighted the rising tide of patients going to A&E.

"We have got growing demand. Over the last decade the number of people visiting our accident and emergency departments has grown from 18.8 million a year to nearly 23 million a year - a 22% increase," Sir Bruce said.

He added: "We need to improve the offer for people out of hospitals, in order to alleviate some of the tsunami of people who are attending A&E, because the lights are on and because they know they'll get a good deal there, and because that they will leave within four hours."

Dr Moulton said: "If you want to look at the demographic growth of the country, we have got a bigger population because of immigration, we have got more elderly, we have got increased birth rate, and a lot of people living longer, so with the demographic change of the country you don't have to be an arithmetic genius to say 'If you've got a 10% bigger country, we need 10% more hospitals'.

"We have got 180-184 DGHs (district general hospitals), so call it 200, if you have got a 10% increase in the country we would need another 20."

He said the alternative to increasing the number of hospitals was solving "flow" problems in hospitals, but the issue has not been tackled in more than two decades.

He continued: "We need as many beds per capita as the rest of the developed world. We need a dramatic increase in the number of beds.

"But we wouldn't need that if we managed to improve flow, but we haven't managed to."

Former president of the RCEM Dr Cliff Mann told delegates at the conference at The King's Fund think tank in London, that there are "perverse" incentives in the system, which mean that patients are being trapped in hospital beds while waiting for social care.

Dr Mann, who now works as a clinical adviser for NHS England as well as being an emergency care consultant, said: "There are perverse incentives within health and social care, otherwise why would you be keeping people in hospital at four times the cost at what it would be cheaper to have them in social care?

"That can only be because you've created systems which encourage that financial madness.

"The problem we have is that we continue to reduce the number of beds, and we have done that incredibly successfully over the last 20-30 years under all forms of government, and that allowed hospitals to strip out costs.

"The easiest way to save £1 million a year is to shut a ward, but you can follow any argument to an absurdity.

"And we have got to a tipping point now when we compare ourselves to international norms to suggest that the capacity to reduce further beds has gone.

"What we must need to do to increase the flow and access to beds is to tackle delayed transfers of care, because these people have been kidnapped by the system."

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