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Here's What British Doctors Think Are The Biggest Problems Facing A&E

The papers are reporting an "A&E crisis" in Britain's hospital wings. But what do doctors say?

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There's a crisis in the National Health Service. At least that's what the media has reported this week: Thousands of people having to wait hours to see a doctor and a government that is blaming this on higher numbers of people going to accident and emergency units.

The news reports also caused such a dip in confidence at the Conservative party headquarters that, as part of his regular Tuesday visits, the prime minister had to this week give a "motivational speech" to the staff, BuzzFeed News has learned.

But what do doctors think? Has the media overblown the situation? We asked a few.

The main reason why people are not getting seen in A&E is not because the doctors are not there to see the patients. In actual fact, I spoke to someone this week who said that they didn't have a ridiculous amount of patients, there just wasn't any space to see them.(Having said that, I'm sure that the number of people attending A&E has gone up generally and that's caused by issues with getting GP appointments etc.)The reason why there is no space in A&E is because of a few things. Firstly, there are many A&Es which have been closed. This, by definition, leads to there being less beds in A&E for people to be seen. Secondly, due to the massive cuts on social care, many elderly patients who are in hospital cannot be discharged, despite being medically fit, as there is no funding for them to be placed (e.g. in residential / nursing home / home with care). Not only does that mean that the beds are occupied by these medically fit individuals, but these people are at further risk of becoming sick due to a hospital acquired infection, leading to further problems. As these beds are occupied, patients who have been seen in A&E and need to be admitted cannot be transferred to the wards (in my hospital on Monday night, this numbered 31 patients). This, in turn, leads to ambulance staff having to wait with their patients in trolleys in the corridor as the patients cannot be left until they have been accepted by the staff in the hospital – who cannot accept the patients until there is an A&E bed available. This leads to the ambulance staff being unable to leave to go to the next call – and that is why the time to wait for an ambulance has also increased.
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Cuts in social care have in my (and many senior colleagues') opinion led to this [the problems]. A push towards the private sector may be a key factor as well. There have been a number of "Pay per Consultation" type clinics set up, which charge £60 for example for a quick consultation (same as A&E), and then recommend treatment.Speaking to some patient's who have used this, they don't mind paying that much to save four hours in a waiting room.There are also a lot of people who come to A&E because they have minor issues, like a tingly cough. And they have to be seen. Having a small fee would stop that.
A&E is a mess across the UK. Last Friday was the worst day my hospital have ever had, with some patients waiting 8 hours before they are seen.Elective [scheduled] operations were cancelled on Monday and Tuesday to help ease the bed situation and enable the movement of patients from A&E into wards.
Scarborough hospital which declared a major incident not because of the pressures faced by A&E but due to the lack of beds available for patients who needed admitting after attending A&E.

A 25-year-old medic in central London said there's just not enough space:

People forget that the word 'bed' in NHS doesn't just mean the furniture... It means nurses and equipment.

When A/E is so packed that Resus [resuscitation units] has run out of space due to never ending blue calls... you get that one anaphylactic patient sitting in a trolley in a corridor with a registrar begging nurses to assist. It's awful and terrifying.

And a 24 year-old , who works at one of the major trauma centres in West Midlands, said people are waiting over five hours to see a doctor:

On Monday evening we had 3 bays [sections of a ward] in majors [acute care] to see patients in overnight – all 27 others were occupied with patients waiting for beds in the hospital so the wait time was over five hours.

Everyone is black alerting [noting that there are no free beds left and new patients at A&E should be sent to another hospital] every five minutes and it's not like we can't deal with what shows up at the door, we just can't shove them out the other end (and then they all end up with a hospital acquired pneumonia or fall or something and get really sick so we cant discharge them.)

More than half of our head and neck cancer surgeries were cancelled on the Tuesday and this is also why people are waiting for operations for longer. If the cancer surgeries are being cancelled (and they have a 62 day limit for head and neck) what hope does anyone else have?

If all our patients left the hospital when we want them to and didn't have to wait for care home spaces it probably wouldn't be this bad. (Care homes and hospices ftw)

I forgot to add we're one of three major trauma centres for the entire west mids - so apparently we're supposed to have space for all the emergencies from all the other hospitals in the region.

The doctors interviewed said they would only speak under condition of anonymity for fear of repercussions from their superiors.

Siraj Datoo is a political reporter for BuzzFeed News and is based in London.

Contact Siraj Datoo at siraj.datoo@buzzfeed.com.

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