Emergency care system 'struggling to cope' while 'many departments spend their time firefighting'
Hospital casualty departments are struggling to cope with growing demand for emergency care because they have too few staff and not enough beds, Britain's top accident and emergency doctor has warned.
As new figures pointed to a steep rise in A&E waiting times and 890 ambulance jobs were lost, John Heyworth, president of the College of Emergency Medicine, joined a growing chorus of doctors warning that the NHS funding pressures are already hitting frontline services.
"The emergency care system is struggling to cope at the moment," he said. "Many departments spend their time firefighting because of the number of patients coming in, the limited number of emergency department staff and limited availability of beds."
David Cameron and the health secretary, Andrew Lansley, have insisted that the NHS will not be affected by the deep cuts to public spending elsewhere and that frontline services will be protected during their shakeup of the health service.
But medical organisations, health charities and patients' groups are increasingly sceptical that the pledge can be kept as health spending fails to keep pace with the rising cost of treating Britain's ageing population.
"The line that the NHS is being protected from cuts – even to frontline services – is looking increasingly absurd", Dr Hamish Meldrum, chairman of the British Medical Association's ruling council, told the Guardian on Tuesday. "The financial pressures are really starting to bite and these are yet more examples of vital services that are showing signs of the strain and that will be stretched to the limit."
Heyworth pointed to NHS figures showing a steep rise in patients waiting more than four hours for A&E treatment, saying they showed "an increasing mismatch between ever rising demand, ever limited emergency medicine consultant numbers, which are woefully inadequate, and limited hospital bed capacity for emergency patients."
The hospital statistics reveal that 292,052 people in England were not treated within the four-hour target between July and December last year, soon after Lansley announced in June that he intended to scrap the rule. That was up from 176,522 patients in the same period in 2009 – a 65% leap inside one year.
The A&E statistics coincided with the axing of 890 jobs by the London Ambulance Service (LAS) and the disclosure that services in which specialist nurses help people with diseases such as cancer and diabetes are also facing cuts.
The ambulance service cuts in London will see 560 frontline posts disappear, including paramedics. The capital may also see some of its ambulance stations close, while, according to LAS chief executive Peter Bradley, solo paramedics rather than two-person crews will start responding to more callouts from September as part of a drive to save £53m over the next five years.
"Unfortunately we are not immune to the financial pressures facing the NHS," he said. "With nearly 80% of our budget spent on staff costs it would be impossible to make the savings required without removing posts." The health union Unison's regional organiser, Phil Thompson, warned the cuts could endanger patient safety. "These cuts are so deep they may not heal. With demand escalating and nearly 1,000 fewer staff no one can now be sure of a safe service."
The ambulance cuts prompted the NHS chief executive, Sir David Nicholson, to issue his second reminder in 72 hours to health service managers that there should be no cuts to patient services as part of the drive to make £15bn to £25bn in "efficiency savings" by 2015.
Cameron, Lansley and Nick Clegg will on Wednesday morning hold their second "listening" event since last week's confirmation that the coalition's plans to radically reorganise the NHS in England were being delayed and a team of experts brought in to improve them. They will meet about 20 voluntary sector and charity leaders at Downing Street to hear their concerns about the plan to hand GPs in England control of commissioning healthcare for patients and about 60% of the NHS budget.