However, the declining number of doctors means that such dictations can simply shift appointments from routine hours to evenings and weekends. It’s like mixing up the sunbeds. And even then, I’m not convinced that the current crisis in hospital care can reasonably fall on the feet of doctors. We see a worrying pattern of failure in acute trusts. Patients wait longer to start emergency cancer treatment, according to the latest Nuffield Trust NHS performance summary, and experience long delays before selective treatment. A&E expectations are higher than ever and trolley expectations over 12 hours are sixteen times higher than they were in February 2021. A system known for “running hot” with extremely high levels of bed occupancy compared to other developed countries has now struck a jolt on the road. Now we see it going off track. This is not because hospitals are overflowing. The occupancy rate in general and acid beds remain below 2019/2020 levels and the most recent published data show that the total number of A&E visits in January 2022 was 6.1 percent lower compared to January 2020. The number of patients who arrived by ambulance in A&E departments is also lower than pre-pandemic levels. Eventually, fewer patients have access to secondary care and hospitals can no longer afford it. A commonly explained explanation is the need to isolate, test, and isolate Covid patients. Additional infection control procedures will undoubtedly also slow down the delivery of acute and voluntary care. The challenges of safe patient rejection in a troubled area of social care will be another contributing factor. In contrast, GP services provide more appointments than before the pandemic. The demand for our appointments naturally increases when patients do not have access to hospital care. We also have an injured and miserable population: mental health presentations have skyrocketed. The problem, then, must first be solved in hospitals. The NHS Trusts is understandably reluctant to relax infection control procedures, fearing the impact of rising Covid rates. But they have to take into account the fact that Britain has just surpassed the biggest Covid wave to date, and there has only been a meager increase in Covid patients needing ICU beds. Waiting 12 hours in an emergency department after a myocardial infarction (or simply not being present at all) is undoubtedly much more dangerous than sticking Covid. No hospital CEO will be applauded for skipping additional hygiene measures or further reducing isolation rules – but it is time to recognize that, in order for the health service to survive at all, capacity levels must now be restored. Unfortunately, we are much more likely to have the same discussion next winter. Dr. Katie Musgrave is a physician in Plymouth
