We're having a lot of excess deaths, but the majority of them are now not from the pandemic.....

Andy_W

Andy_W

Well-known member
This Twitter thread from John Burn Murdoch looks at the current A&E crisis, and how that's causing 500 excess deaths per week in the UK, which is now more of a problem than Covid, on its own. Fair to assume the same reasons for the A&E failures are causing excess deaths elsewhere also.

This is what the Tories do for the NHS, screw up investment, screw up ambulances, screw up A&E waits, screw up available beds, screw up social care, screw up preventative measures and you end up with an absolute **** storm. I knew it was bad, but didn't realise it was this bad.

A massive cause is the lack of beds that we have available, which has been declining since the Tories got into power (was 14%, now 7%). Another problem is we have double the number of people waiting to be discharged in beds than we do have available beds. We now have 13% of beds occupied by people waiting to be discharged! The main reason they've not been discharged is that there's nowhere to discharge them to, underfunded social care and support, lack of care home beds etc. Then along with that loads of other issues to do with being understaffed.

Hospital admissions are lower than 2019 too, and less of the A&E admissions are requiring a hospital bed, so we're having major problems, and it's not because we have more people attending the hospital/ A&E and needing beds. We just can't get those in beds who need them, and then once we do we can't get them out.

Shocking state of affairs, and our problem is getting worse, worse than all of Europe and we're getting worse, and they're all getting better.

Our current excess deaths are 9%, and there are zero excuses.

https://twitter.com/x/status/1562004612172873728
 
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Our Trust used to hold emergency meetings if we had 3 people waiting in beds to be discharged. We're running at about 20 at a time now. It's a huge number because it prevents people that need treatment from being seen. It costs about £400 per day to be in a hospital bed. It's a massive issue.
 
I was in a&e a couple months ago, nothing too serious. I got there at 11pm, was there until 7am and they said another 3 hours to see a doctor, I walked out.

It’s sad because a few people were having a go at the staff but it’s not their fault at all. Most people in there did seem to understand and sympathise with the staff thankfully.
 
Chappy112 said:
I was in a&e a couple months ago, nothing too serious. I got there at 11pm, was there until 7am and they said another 3 hours to see a doctor, I walked out.

It’s sad because a few people were having a go at the staff but it’s not their fault at all. Most people in there did seem to understand and sympathise with the staff thankfully.
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I've had a few broken bones in the last year and not bothered to go to A&E or even a Walk in, last couple of times I've not even bother with 111 or anything, it's a sad state of affairs. Thankfully ( :unsure: ) I've got a lot of experience in having broken bones, so have got quite good at sorting myself out and have resorted to guessing/ assuming an X-Ray is a waste of people's valuable time. I also know a few who work in A&E and other areas, and try and make the most out of 111.

My partner had to go to A&E the other day and was in there 9 hours, and she said the abuse the staff were getting was off the scale, shocking.
 
A&E isn't first come first served. Everyone is triaged so while one person has an 11hr wait another might only wait 15 minutes. If you are waiting 11 hours it probably is because they have deemed you not a priority. It used to be that those non-priorities would be seen within the 4hr target but that target is so far in the distance now that it is no longer relative. If you are seen within 4 hours then you have been lucky. If you are in urgent need then you will probably be seen fairly quickly even when it is busy. Also, if you go past 4 hours then you've already missed the target so it makes more sense for them to stop other people breaching the target than to treat someone that is already in the statistics which is a clear downside of target-driven performance management.

It's not A&Es fault. It's a system and they are just a small part of the system. Unfortunately they are the first point of contact for most patients so bare the brunt. Patients can't have a go at there not being enough care homes so they take it out on the A&E staff.
 
Nano said:
A&E isn't first come first served. Everyone is triaged so while one person has an 11hr wait another might only wait 15 minutes. If you are waiting 11 hours it probably is because they have deemed you not a priority. It used to be that those non-priorities would be seen within the 4hr target but that target is so far in the distance now that it is no longer relative. If you are seen within 4 hours then you have been lucky. If you are in urgent need then you will probably be seen fairly quickly even when it is busy. Also, if you go past 4 hours then you've already missed the target so it makes more sense for them to stop other people breaching the target than to treat someone that is already in the statistics which is a clear downside of target-driven performance management.

It's not A&Es fault. It's a system and they are just a small part of the system. Unfortunately they are the first point of contact for most patients so bare the brunt. Patients can't have a go at there not being enough care homes so they take it out on the A&E staff.
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Yeah that had to be explained to someone when I was in, he ended up being chucked out by security. He was constantly ******* and moaning, having a go at staff because people were being seen before him who arrived later.
 
I've been in a couple of times in the last couple of years with post op bleeding and pretty much seen straight away, or within an hour in a fairly full waiting room.

As a nurse we always had spare capacity for emergency use, that was in the early days of Thatcher, before the cuts started to really take effect.
 
Chappy112 said:
Yeah that had to be explained to someone when I was in, he ended up being chucked out by security. He was constantly ******* and moaning, having a go at staff because people were being seen before him who arrived later.
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It's mad how people with a broken finger or a limp etc, think that they should be seen before someone coming in later with a suspected heart attack or serious symptoms. They should have called it E and A, with a big emphasis that Emergency comes first.

Still, waiting 8-12 hours with a broken bone or something similar is pathetic, and it's purely down to lack of staff, lack of funding and lack of support/ secondary aspects to hospitals and we can blame the Tories for all of that. They can no longer use the pandemic as an excuse, and it's now becoming clearer by the day.
 
They've been seeing cuts over the past decade haven't they? Why now?
I have had treatment for 4 different things since COVID. I think one is related to long COVID. I think another is down to lockdown. Another is something I couldn't get dealt with during lockdown.
 
Sheriff_John_Bunnell_ret said:
They've been seeing cuts over the past decade haven't they? Why now?
I have had treatment for 4 different things since COVID. I think one is related to long COVID. I think another is down to lockdown. Another is something I couldn't get dealt with during lockdown.
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Have a read of the twitter thread, explains it in good detail, but I'll summarise it roughly.

We've gone way below the danger line in % no of available beds, at the same time we can't get people out of beds who shouldn't be in beds, as there's nowhere to put them and no staff to administer it.

1661254469606.png

Less are needing A&E than the trend, so it's not because admissions are up
1661254598697.png


Less attendances need admission to beds, so it''s not because of that either.
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Beds should have been keeping up with the trend, not declining when it's increasing. The same with social care aspects and staffing, they've both gone down when they should ahve gone up to maintain the same level of care.

The reason the A&E admission numbers are trending up is because the population is increasing, and getting older, which shouldn't have been a surprise and could have been forecast 20 years ago.
 
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Sheriff_John_Bunnell_ret said:
They've been seeing cuts over the past decade haven't they? Why now?
I have had treatment for 4 different things since COVID. I think one is related to long COVID. I think another is down to lockdown. Another is something I couldn't get dealt with during lockdown.
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The cuts take a while to manifest together with a high level of anxiety in the population perhaps?

We have seen the reliance on the NHS increase since we started to become a more uncivilised place to live.

Pay people fairly, give pensioners a fair return for their contribution, cut working hours back etc and we'll see the amount we need to spend on the NHS come down.

Of course the Tories would never be in government again for that to happen but some scrotes will still vote for them.
 
Its terrifying to think if you had a serious incident now you would likely be dead waiting for an ambulance to arrive. Read a story yesterday about an old man who had to wait 15 hours for an ambulance after a fall in his garden, his family had to build a tent over him to keep him warm.

Would be interesting to get the thoughts from the torys on here about this, still happy with your decisions?
 
Andy_W said:
Have a read of the twitter thread, explains it in good detail, but I'll summarise it roughly.

We've gone way below the danger line in % no of available beds, at the same time we can't get people out of beds who shouldn't be in beds, as there's nowhere to put them and no staff to administer it.

View attachment 43332

Less are needing A&E than the trend, so it's not because admissions are up
View attachment 43334


Less attendances need admission to beds, so it''s not because of that either.
View attachment 43333

Beds should have been keeping up with the trend, not declining when it's increasing. The same with social care aspects and staffing, they've both gone down when they should ahve gone up to maintain the same level of care.

The reason the A&E admission numbers are trending up is because the population is increasing, and getting older, which shouldn't have been a surprise and could have been forecast 20 years ago.
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I would also guess that these figures are fudged slightly and they are only counting Type 1 A&E attendances. My Trust has added a Minor Injury Unit. All those people used to be seen by A&E. Everything gets triaged and about 25% of patients are sent there. If you only count the people that are triaged to A&E then the number will have reduced. If you count all of the people that turn up at A&E then they number has increased. Our total is about 10% higher than 19/20.
 
Nano said:
I would also guess that these figures are fudged slightly and they are only counting Type 1 A&E attendances. My Trust has added a Minor Injury Unit. All those people used to be seen by A&E. Everything gets triaged and about 25% of patients are sent there. If you only count the people that are triaged to A&E then the number will have reduced. If you count all of the people that turn up at A&E then they number has increased. Our total is about 10% higher than 19/20.
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I'm not sure, can't imagine JBM would have missed that, as he was given all the granular data, working on it for a week, not sure how to go about checking that mind. The beds aspect is bang on though, as is the number of total admissions following a visit, would be difficult to assume numbers of visits are up if admissions are down etc, would expect that to go hand in hand.

Each trust will be different of course.
 
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