This is the 137th #WILTW

Every winter is tougher, busier and more draining than the last with an unremitting year-on-year rise in demand:

• Emergency admissions from major A&E departments have increased by an average of 4.3 per cent a year since 2003/4
• Attendances at outpatient clinics have risen by an average of 3.8 per cent a year since 2007/8
• Admissions for planned treatment have increased by an average of 4.3 per cent a year since 2003/4.

It is no surprise then that within, and without of healthcare, people are wondering how long things can continue with flatlined funding before the NHS completely collapses.

There is a slight problem though.

Because we have been here before.

For at least the past 3 winters think-tank and media reports have warned the current situation is the worst ever.  In December 2015 #WILTW responded to an article by BBC Health Editor Hugh Pym which concluded:

“..Twas ever thus and the NHS has got through previous winters despite forecasts of doom and gloom..”

This does prompt the question of what actually is it that might ‘collapse’? The NHS isn’t going to go out of business, close its doors and turn off the lights. What I think professionals fear the most is that they will be delivering a service that isn’t safe or sustainable. There are those  who already say emergency care is out of control but we are not (yet) repeating the past when huge waits in Emergency Departments and for elective surgery were the norm. However people do fear being overwhelmed by what they need to do on a day-to-day basis to keep the health system ticking over.

Staff resilience as a whole though is incredibly strong. I wrote last year:

It is the spirit which provides energy through a simple knowing look when the queue of patients to be triaged doubles. It is the spirit that provides resolve when a doctor and nurse go together to break bad news. It is the spirit that acknowledges gallows humour, not as demeaning to patients, but as a way to deal with the shared pain of some of life’s tragedies. It is a spirit that says, “I’ve got your back, because you’ve got mine.

But will this be its undoing if the 2018 headlines read: “NHS again at tipping point” or is it that the cycle of care is such that we thrive on a crisis? It may well be time to decide what our real concerns are because otherwise the NHS will remain at risk of being taken for granted.

What have you learnt this week? #WILTW

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