NHS 'overcrowded and short-staffed'

Herald Series: The Royal College of Physicians says hospitals are so full that routine blood tests are being conducted at 3am The Royal College of Physicians says hospitals are so full that routine blood tests are being conducted at 3am

Hospitals are so full that elderly patients are being discharged in the middle of the night and routine blood tests are being conducted at 3am, the Royal College of Physicians (RCP) has warned.

As bed spaces for acute care become increasingly under demand, patients are being turfed from ward to ward which is leading to a poor continuity of care, it said.

Doctors on wards up and down the country are struggling to care for patients who require urgent or emergency care, according to a damning report, Hospitals On The Edge? The Time For Action.

As queues at the doors of accident and emergency wards increase, patients who are already admitted to the hospital are shipped from one ward to another "like parcels", to make bed space. This is leading to fractured care and a lack of compassion that may occur as a consequence, said RCP officials.

A dwindling number of specialist medics working out of hours and staff shortages in key emergency care departments and are putting strain on services. One in 10 consultant posts in emergency medicine are currently vacant, said the RCP.

While the number of patients has increased, the number of beds in general and acute wards has fallen by a third in the last 25 years.

"Hospitals have filled up," said Dr Andrew Goddard, medical director for the RCP workforce unit. "This has been coming on for a while. We have managed to cope with it but the system can't cope much longer, and we need to radically rethink how we provide the care for acute medical patients, particularly the elderly."

Professor Tim Evans, lead fellow the RCP's Future Hospital Commission, said if action is not taken, there could be a reproduction of the tragic events at Mid Staffordshire NHS Foundation Trust where as many as 1,200 patients may have died unnecessarily because of poor care. He said: "There will not be some cataclysmic overnight explosion but there will be a gradual increase in the sorts of tragedies that we've heard about at Mid Staffs. All hospital inpatients deserve to receive safe, high-quality, sustainable care centred around their needs and delivered in an appropriate setting by respectful, compassionate, expert health professionals. We must act now to make the drastic changes required to provide the care they deserve."

Alzheimer's Society chief executive Jeremy Hughes said: "People with dementia are going into hospital unnecessarily, staying in too long and coming out worse. Supporting people to live well at home and reducing the length of time a person stays in hospital can both improve quality of life and save the NHS hundreds of millions per year."

Health Minister Dr Dan Poulter added: "We are modernising the NHS so it can continue to do more and improve care - putting doctors and nurses, those who best understand the needs of patients, in charge of improving the NHS. To properly provide dignity in care for older people, we need to see more care delivered at home and in the community."

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