How long can the NHS be peri-arrest? #WILTW

This is the 168th #WILTW

December 2015: How the NHS spirit pulls through (WILTW 82)

Hugh Pym, the BBC’s Health editor, wrote on “The NHS in Winter – an alphabet soup of stats” this week. The article explores the reasons behind publishing the national Accident & Emergency 4 hour target results monthly, instead of weekly. What caught my attention was the penultimate paragraph

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

December 2016: Is the NHS crying wolf? (WILTW 137)

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

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.

December 2017: How long can the NHS be peri-arrest? #WILTW (168)

There is an almost metronomic quality to the annual winter crisis that hits the NHS. Dependant on your political persuasion the underlying reasons are irreconcilably different but I don’t think anyone feels comfortable that acute and emergency services becoming overwhelmed too often feels like a surprise.

How many times did Peter cry wolf before he was ignored? Personally I think there has been a slightly different feel to this winter. I swing between either worrying that this might be acceptance of an untenable situation or being very proud of my staff for once again raising their game in often the most difficult of circumstances.

Actively learning from previous winters has definitely helped and there have been changes in staff numbers. It also appears the childhood flu vaccination policy may have helped mitigate the flu epidemic that recently ravaged Australia and New Zealand. But without a doubt presentations have increased again, there appears to be no real change in acuity and you can sense the underlying fatigue as one difficult shift merges into another difficult shift.

There are concerns that a different media approach may also be hiding some of the hysteria that swept new outlets last year as the King’s Fund and Nuffield Trust continue to report the huge pressures facing the NHS.

But if the winter passes again will anyone believe that the status quo isn’t sustainable? In the midst of the most flat funding that the NHS has ever received, but we don’t fall over?

Yet.

Ben Symons wrote eloquently and passionately on the need for leaders to create environments where they actively listen and explore concerns not just hope that juniors will ‘speak up’ if they give them permission to.

We need to keep listening, keep examining and keep discussing the approach to the delivery of acute healthcare. It is vital the public continue to believe us.

What have you learnt this week? #WILTW

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