Action needed now to avoid worst NHS winter yet

The Care Quality Commission has stressed that action must be taken now if the NHS is to avoid an even worse winter crisis next year.

Ted Baker, hospitals chief inspector, said that the use of corridors to treat sick patients in A&E was ‘becoming normalised’, with departments struggling with a lack of staff, poor leadership and long delays leading to crowding and safety risks.

The hospitals inspectorate has carried out more than a dozen small one-day inspections of A&E departments since December where it had specific concerns about possible safety risks. It has emphasised that capacity issues traditionally reserved for the winter months were now year-round problems. July 2019 saw the highest proportion of emergency patients spending more than four hours in A&E than any previous July for at least the last five years.

The CQC also warned that poor cooperation and coordination between hospitals, social care and other local organisations had ‘led to fragmented care’ in some places, something that would not be solved with a ‘quick fix’. Furthermore, A&E departments were found not to have enough nurses with the skills and qualifications to care for children, while inspectors found long delays in ambulance staff handing over patients to the A&E team were causing crowding and patients waiting in corridors.

Baker said: “Our inspections are showing that this winter is proving as difficult for emergency departments as was predicted. Managing this remains a challenge but if we do not act now, we can predict that next winter will be a greater challenge still. We cannot continue this trajectory. A scenario where each winter is worse than the one before has real consequences for both patients and staff.”

The latest NHS performance data showed record numbers of patients waiting on trolleys in A&E departments, with 2019 seeing the worst cancer performance by the NHS since 2016.