‘High degree of concern’ about NHS pressures reached even before winter peak

The NHS is operating under an “unprecedented degree of pressure” even before the traditional winter peak in January, a health leader has warned.

With some 5.9 million patients on the waiting list in England, NHS Providers boss Chris Hopson said trying to work out how high the figure could rise was a “guessing game”.

But, offering the public reassurance, he insisted health staff are “working absolutely flat out”.

It comes as the chief executive of the Royal College of Emergency Medicine (RCEM) said stopping “dangerous” crowding in emergency departments should be the Government’s number one priority in hospitals.

Gordon Miles issued his warning after a report found thousands of excess deaths were caused as a result of crowding in emergency departments due to lengthy waits for treatment.

The RCEM said crowding is associated with increased mortality and increased hospital length of stay, and also affects efficiency in hospitals and contributes to staff burnout.

Mr Hopson said there is a “high degree of concern” about the challenges the health service is facing, as he described “very high levels of volume of people coming into accident and emergency departments” as well as “real pressure” on ambulance services.

He told Sky’s Trevor Phillips On Sunday programme: “The NHS is under an unprecedented degree of pressure for this time of year, and of course that’s before the traditional winter peak.

“We know that the NHS tends to feel most pressure in early to mid-January. So there is a high degree of concern.”

He added: “Obviously this is what the NHS is here for.

“We’re here to provide the best quality of care to everybody who needs it, and our staff are working absolutely flat out to ensure that we deliver in line with the NHS constitution, because that’s what we’re here for.”

Health Secretary Sajid Javid repeated his warning that the current waiting list figure, which he gave as 5.9 million people waiting for elective procedures, “is going to go up before it comes down” as millions who stayed away during the height of the Covid crisis return to seek healthcare on the NHS.

He told Sky: “But I want them to come forward, I want them to come back to the NHS, I want them to know that it is open to them, and if you take that along with normal demand, of course that is huge pressure.”

Mr Hopson said: “We simply don’t know how many people who didn’t come forward during Covid-19, during the pandemic, will actually come forward, and therefore we are in a bit of a guessing game about exactly how many.”

But he added that both staff and leaders in the NHS “are working incredibly hard at the moment to create that plan to ensure that we can get through that backlog as quickly as possible”.

Mr Javid acknowledged that the Government was not on track to recruit its target number of GPs by 2025, telling the BBC’s Andrew Marr show: “We are not on course at the moment. Not for the 6,000. Let’s wait and see where we eventually get to.”

The RCEM’s report said crowded emergency departments “delay and dilute the quality of care”, and although this might not have an immediate effect on the patient, argued that it increases their risk of death after leaving the emergency department.

Dr Miles said demand and capacity in emergency care are “severely mismatched”.

“Emergency departments now sustain other parts of the healthcare system and are the first port of call for many patients, despite not always being the most appropriate place to receive care,” he added in a letter to The Sunday Times.

“There is an urgent need to plan for our future healthcare requirements — and eliminating dangerous crowding in emergency departments must be the number one priority.”

The college’s report, published days earlier, suggested at least 4,519 patients died as a result of crowding and 12-hour stays in A&E departments in England in 2020-2021.

The report stated: “If we assume that the harm suffered between eight to twelve hours continues in patients who stay longer than 12 hours, then 4519 excess deaths occurred in England.”

It said the discovery adds to NHS England’s own findings that one in 67 patients staying in the emergency department for 12 hours comes to excess harm.

After its publication, the college called on the Government to publish a long-term workforce plan, including provisions to retain existing staff who are reaching burnout and obtaining new recruits.