John Hope and his daughter Cleo, whose 111 doctor’s appointment was cancelled due to an unprecedented number of calls. Image: Supplied
An 85-year-old woman lying on the freezing concrete pavement for hours waiting for an ambulance. A six-year-old with suspected Strep A having her emergency doctor’s appointment cancelled due to demand. A young woman fitting in the A&E waiting room as nurses rush to her side. A 77-year-old stuck in the back of an ambulance for 18 hours. This is a snapshot of the NHS crisis as we enter 2023.
Over a decade of underfunding, staff shortages and a workforce exhausted by the pandemic has led the national health service to breaking point. And now it is having a harrowing impact on patients across the country.
Matthew Taylor, chief executive of the NHS confederation, says the pressures on staff are becoming unbearable and it is likely the situation will only get worse in the next few months. He adds there are “deep-rooted problems” facing the NHS which the government must confront.
Families are facing emergency situations every day. George Massey’s 85-year-old mother was lying on the concrete floor after falling down steps, breaking her femur and shattering her ankle. A family friend found her on the floor, called an ambulance and contacted the family.
He was told it would be eight hours before the ambulance arrived and he did not think Massey’s mother would survive. She was lying in the freezing cold and has a heart condition. Had the family not been able to take her to hospital themselves, the outcome could have been very different.
“It was horrendous. I was in tears,” Massey says. “I’m 60 years old but you never want to see your parents like that. Somebody had brought a large rug and managed to wiggle my mum onto this. She was shivering cold. She couldn’t walk. A few of us managed to drag her down the steps and we had to put her in the boot of my car.
“I drove the car and I was in a bit of a stress and panic and I managed to see these two paramedics with the ambulances and I just said: ‘What do I do? I’ve got my mum in the car.’ They were astonished. They were so shocked. They came up to the car, lifted her out the car and went through the procedure. They gave her gas. They were really good with my mum.”
Another family had a similar experience. Leigh Woods says her father was lying on the cold concrete pavement for eight hours from 2am – fortunately, two strangers found him and stayed with him through the night. She said: “I appreciate that the NHS is under pressure but he was lying there freezing cold for more than eight hours unable to move.”
After Massey’s mother had been put in a wheelchair, she was taken into A&E. It was “mayhem” and “absolutely chockablock full”, Massey says. A girl had a fit in the waiting room and nurses rushed to her side. He tried to be as calm as he could – there was nothing they could do but wait their turn.
Massey stayed with his mother for five hours before he had to leave. She was on her own before she was taken into the ward. He was unaware of the scale of the NHS crisis until he experienced it for himself.
The Department for Health and Social Care (DHSC) admits there are pressures facing the healthcare service, and the NHS will set out “detailed recovery plans for urgent and emergency care” in the new year. It hopes to improve ambulance response times to 30 minutes and reduce A&E waiting times.
Rising costs have eaten into the NHS budget, according to recent research from the Institute of Fiscal Studies (IFS). Even though the government has allocated an extra £3.3bn in 2023 to 2024 to the NHS in the Autumn Statement, this will only undo around half of the real-terms hit from higher inflation.
A spokesperson for the DHSC says: “The government prioritised health and social care in the Autumn Statement, making up to £14.1bn available for health and social care over the next two years, on top of record funding to reduce waiting times improve urgent and emergency care and returning performance to pre-pandemic levels.”
But, according to the IFS, around £4bn of additional funding on top of this will be needed in 2024 to 2025 to make up for the shortfall caused by inflation.
“I was oblivious to all this,” Massey says. He is sympathetic to NHS workers, but he feels more staff and beds are needed. “I didn’t know how bad it was. You listen to the news but, to experience it for yourself, it really hits home.”
The IFS has found that even after adjusting for higher rates of staff sickness absences, the NHS has 8 per cent more nurses, 9 per cent more consultants and 15 per cent more junior doctors than pre-pandemic. But it’s not enough to meet soaring demand.
According to a report by the parliamentary Health and Social Care Committee, the NHS and the social care sector are facing the “greatest workforce crisis in their history”. The latest NHS vacancy statistics show that overall, full-time staff vacancies in NHS trusts in England increased from around 133,100 in the quarter to June to around 133,400 in the quarter to September.
Taylor, of the NHS confederation, says: “We need the government to commit to do everything within its power to prevent the NHS from entering the next winter in this same fragile state that has sadly become the norm over recent winters. This starts with negotiating with the unions on pay so we can avoid more damaging strike action when services will be at its most fraught.”
Experiencing the fraughtness of the NHS crisis firsthand, Louise Walters spent 18 hours in an ambulance with her mother and five hours in A&E. “I am not in any way blaming the NHS for its current state,” she says. “They have done an outstanding job with what they have. But it’s not enough. People will die from lack of resources and supplies.”
The spokesperson for the DHSC said the NHS is providing “targeted support to some of the hospitals facing the greatest delays in the handover of ambulance patients into the care of hospitals”. They added that NHS England allocated £150million of additional funding for ambulance service pressures in 2022/23.
In a harrowing post shared on social media, Walters said she was glad her mother was in the ambulance getting one-on-one care. She wrote: “It was like a war-torn, third-world hospital. No chairs, people on the floor wailing and crying, hollowed-eyed children staring into space too shell shocked to speak. A woman, gasping for breath, grey and sweating, unable to breathe but no oxygen able to be offered.”
She says there were paramedics leaning against the side of their vans, exhausted and emotional. She watched a man drive up to the hospital blaring his horn, his “young son blue and fitting in the back of his car” – he had been told it would be 15 to 30 hours for emergency care.
“None of this is about pay,” Walters added in her post. “Medics are striking to try and bring attention to the terrible state of the NHS, the ridiculous working conditions and the plight of the patients. People are dying. Mum is about to be moved into a bed in A&E. We’re petrified. It’s chaos.”
Another family who fell victim to the NHS crisis is John Hope’s. His six-year-old daughter Cleo had suspected Strep A. After 10 days, her symptoms grew worse – she had a high temperature and was struggling to swallow. Hope called 111 just before midnight and was told a doctor would call back within the next six hours. They waited through the night, with broken sleep, and it wasn’t until 6am that they received a text message.
“Due to an unprecedented number of calls we are unable to provide a call back at this time and your case has been closed,” it said.
“I was in complete disbelief,” says Hope. “I’ve had a lot of concerns around the NHS for the past few years. It just seems to be getting worse and worse. I’ve got friends that work in various positions in the NHS who are always going on about how much pressure they’re under. But it isn’t until you see it firsthand that it really comes home.”
They eventually managed to get an appointment but, even then, their local pharmacies didn’t have enough stock of the antibiotics she needed. Cleo has made a recovery, but Hope still hasn’t got over the shock of the experience.
“As a parent, you’re angry,” he says. “It’s one thing if it happens to yourself but it happening to a young child is what makes it shocking. There needs to be more investment in the NHS. It needs to become more efficient. It’s not as simple as just throwing a load of money at it.
“I’ve got no issue with nurses striking. They’ve had a real-terms reduction in their pay. You hear horror stories about the extra hours people are having to work and the pressures they’re under because there’s a lack of beds. It’s not an appealing place to work.”
Further details of the government’s response to the NHS crisis can be found here.