The Epsom & St Helier NHS Trust have missed the government target for A&E waiting times every month since August 2015.
Until recently, the government target for the percentage of A&E patients to be seen within 4 hours was 98%, but in June 2010, the Con-Dem government relaxed this target to 95%. There are a number of factors which have contributed to the national average deterioration, and indeed the Epsom & St Helier Trust, failing to meet the current government target for A&E patients being seen within 4 hours. These include:
Staff shortages, caused by a combination of:
- Budget cuts and "efficiency savings" imposed first by the Con-Dem and now Conservative Government
- Very low staff morale, as a result of the way in which NHS employees have been treated by the government (Junior Doctors contract, removal of nurses bursaries, Nurses pay etc.). This has led to many leaving the profession, and in some cases the country.
Increased demand, caused by a combination of:
- Population growth
- More cases being referred by NHS 111, indeed the president of the college of emergency medicine has stated that the "Rise in A&E attendances (has been) caused by NHS 111"
A lack of available beds to admit patients, caused by a number of factors including:
- A reduction in the number of available beds
- A reduction in Social Care budgets (so-called "bed blocking" - not a phrase we like as it implies that it is the fault of the patient and not of the system).
A reduction in the number of General Practitioners, caused by:
- Funding cuts leading to an increase in the number of GPs leaving or retiring early from the profession.
- A recruitment crisis, as the profession is no longer considered as attractive as it used to be.
While the Epsom & St Helier Trust has failed to meet the June 2010 government target of 95%, every month since August 2015, it has remained considerably better than the national average, and roughly on par with the other hospitals in the South West London sector. For us at KOSHH, this news raises a number of important points:
- This data confirms yet again, our view that we can certainly not afford to lose the beds provided by Epsom & St Helier, as this would make the performance figures for all of the remaining hospitals in South West London considerably worse than they already are. Furthermore, any reduction in bed numbers across the region would further exacerbate the situation.
- The loss of the NHS Direct service, which was staffed by clinicians, and the replacement of it with the inferior (and privately provided) "NHS 111" service was a big mistake. This has led to significant increases in A&E and Ambulance service demands. This decision should be reversed forthwith.
- The Health and Social Care Act 2012 effectively abolished the National Health Service as we knew it, allowed the private sector into the NHS like never before, and has led to a situation where the administration of the "market" which enforces that services be put out to tender by "Any Qualified Provider" is costing you and me somewhere between 5 and 10 billion pounds to *administer* every year - and we at KOSHH believe that this money should instead be going into patient care.
- The proposed removal of nurses’ bursaries, cuts to pharmacy services, and the general running down of all professions within the NHS is only going to make this situation get worse in the future.
Please find below a table showing the data for the Epsom & St Helier Trust only, from June 2015 until January 2016. The England wide statistics can be found here.
It is important to note that the above statistics are certainly not worse than the national average however. This crisis has not happened all over the English NHS by a strange coincidence, It certainly was not by accident.
You can read the local guardian's coverage of this story here or below.