London hospitals in crisis

Emergency care in deeper crisis than ever before

Last week the most senior doctor in London working in emergency medicine broke cover and warned urgent and emergency care is in a deeper crisis than ever before. Katherine Henderson, President of the Royal College of Emergency Medicine published the truth about the full extent of the crisis in hospitals, that there are severe and dangerous delays:

“Patients waiting hours at home for an ambulance or waiting hours to be seen and treated in our emergency departments.”

Now Professor Jeremy Levy, an NHS consultant who lives in Chiswick and works in London hospitals has shared his experience with The Chiswick Calendar:

“Ambulances are queuing because patients seen in emergency departments cannot be admitted, because no beds are available, because patients cannot be discharged into nursing homes or their own homes when needing community nurses.”

He receives ‘Black alerts’ on his phone almost daily, issued when a hospital is stretched to capacity and is under extreme pressure, with patients building up in emergency department awaiting admission.

Thoughts from the NHS front line

By Professor Jeremy Levy

So Boris Johnson, Rishi Sunak, and their supporters, really don’t think that breaking the law was a problem, and many of their supporters think their behaviour was just what we all did during the Covid-19 lock-downs of 2020 and 2021. Attending parties was normal, apparently. And of trivial importance. And this seems to be the general belief of the Conservative party.

I am an NHS consultant working in London. During April and May 2020, I repeatedly worked on wards looking after patients with Covid-19. From my first day on a Covid ward, large numbers of patients died. During my first ward round in April 2020, three people died on a ward of 22 patients within 24 hours, from Covid-19. Without relatives comforting them.

Patients, families and NHS staff suffering huge distress. Even forgetting the people who could not attend weddings and funerals, loved ones in care homes, dying relatives, over two years I did not attend a single party. There were none.

No parties in the NHS

Colleagues died and we could not join in any memorials. Long standing colleagues retired and we did not celebrate. Colleagues were promoted and won accolades and we did not celebrate. Not once. We worked, we went home, we worried about infecting our families.

We did not socialise at all at work or after work. We did not bring bottles to work. But for the prime minister, the rules he made were irrelevant and not made for him and his colleagues. The callous disregard and breath-taking lying is astounding, and simply confirms that they believe “they” are not “us”.

Covid-19 has NOT gone away. Do not believe the Tory ministers. Every day we are juggling huge rates of staff absences because of Covid. Operations are cancelled. Clinics are cancelled. Ambulance crews are absent. Patients are piling up throughout the system and not getting the treatments they need.

Patients still get Covid and those with compromised immune systems get ill. We still have over 100 patients in my hospitals with Covid, and this is not diminishing, and across the UK thousands of people are still dying from Covid-19.

Image: Black capacity alerts – Texts Professor Levy receives telling him his hospital is is under extreme pressure until they have freed up some more beds 

Black capacity alerts ping on my phone warning his hospital is under extreme pressure

Wating lists to see a Neurologist are now over a year in many places, ongoing Covid making this unremitting. In my speciality area, patients often wait in outlying hospitals for my specialist care for over a week before we can move them, with treatment delayed and potentially care compromised. And our political leaders do not seem to care.

Some friends, active members of the Conservative party, simply believe the NHS inefficient and these problems are not caused by politicians. Look, they say, at the Cromwell Hospital in Kensington or King Edward 7th Hospital off Harley Street.  We never have to wait for a bed there, they say. They are well run, and this is the problem with the NHS, they say.

This is simply not true. Private hospitals are efficient because they do not accept any emergency patients, no patients who just walk in, no patients needing social care, no patients with complex needs nor mental health problems.

No patients with acute heart attacks, acute strokes, needing emergency kidney transplants, with multi-organ failure. And if they are full, they just say “no”. And if the patient has complex or expensive needs, they just say no. The NHS cannot say “no”.

Ambulances are queuing because patients seen in emergency departments cannot be admitted, because no beds are available, because patients cannot be discharged into nursing homes or their own homes when needing community nurses … because there is no money from government to fund community services, to fund district nurses, to support a living wage for care home staff, and of course Brexit has removed many European staff. And Covid is reducing staff too.

The government has been in power for 12 years. This is a problem of their making. An underfunded NHS, with too few doctors and nurses, too few beds, too few scanners, too few care-home staff too badly paid, and no actions in hand.

And of course now it is not solvable overnight. But fundamentally a problem owned and caused by the party in power for 12 years. Who blithely partied when telling all of us to stay home in a pandemic.

Did you party when lock-down was imposed? Did you miss a birthday or funeral or wedding or leave a loved one unsupported in hospital or a care home? And are you now waiting a prolonged time for medical care, which should not be happening in a wealthy 21st century country?

Professor Jeremy Levy is an NHS consultant who lives in Chiswick and works in London hospitals.

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