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The UK is about to face one of its worst flu epidemics – and there’s no NHS money to prepare for it. The Government can’t say it wasn’t warned

Posted on 15/09/2017 by


Every part of the country faces a major crisis this winter as a result of the ruthless spending squeeze in NHS, social care and public health

​Independent Voices

The NHS is braced for another winter flu epidemic 

In a memorable 2015 TED talk, Bill Gates told his audience that “when I was a kid, the disaster we worried about most was a nuclear war.” But today he says “if anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus, rather than a war. Not missiles, but microbes.”

The consequences of a major flu pandemic would be world-changing. In 1918, a flu pandemic killed 50 million to 100 million people – at the top end, more than the combined total casualties of World Wars I and II – and for a slew of reasons, humans are arguably more vulnerable today than they were 100 years ago.

The situation in England is very critical – the NHS is not equipped to cope with any serious flu epidemic. The NHS is under tremendous pressure, as is now widely acknowledged. As social services for home helps and other care funding has fallen by 11 per cent in five years, this has resulted in serious bed blocking, with more than 2,500 hospital beds a day taken up by patients whose release has been delayed due to problems in the social care system.

The number of yearly visits to A&E departments of all types of presentations increased by 9 million between 2000/01 and 2015/16. The Royal College of Emergency Medicine says hospitals must more than double current number of consultants to ensure safe care.

GPs are seeing more patients than ever – an increase of 15.4 per cent since 2010-11, with more than 350 million consultations every year – but access to appointments is still problematic for many. 

So, it is of no surprise then that Simon Stevens, the CEO of the NHS England, has warned of a more pressurised flu season this year. Hospitals and GP services have been urged to brace themselves for an epidemic this winter. NHS England has promised to free up between 2,000 and 3,000 extra beds to help avoid a repeat of last year’s struggles – but where are the nurses and doctors to cope with this pressure?

It’s all very good warning that there’s going to be an epidemic, but isn’t it more frightening that the NHS is wholly unprepared to actually deal with it?

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Every part of the country faces a major crisis this winter as a result of the ruthless spending squeeze in NHS, social care and public health. The majority of NHS trusts in England are deeply concerned about the NHS’s inability to respond to mounting pressures this coming winter.

The real issue for many trusts is that the extra funding promised (£1bn) for social care, partly allocated to ease winter pressure on the health service, is not getting through to the NHS.

The clear message is that many places will struggle this coming winter. Majority of trusts report a lack of capacity in primary care, social care, mental health, community services, a lack of acute capacity and a lack of ambulance capacity to manage this winter. There is a clear risk that, as pressures continue to grow, the difficulties encountered last winter will be more severe and extensive this coming winter.

The pressing issue with a flu crisis is that if an elderly individual contracts the virus, it can be more dangerous and debilitating – hence a hospital admission may be necessary. But social care intervention may be needed to help them return home. If there’s no funding or services available, their hospital discharge will be delayed. This sort of scenario will repeat itself over and over this winter – just as it did last year. And we are not prepared for it, yet again.

To manage this risk, the health service needs the added NHS capacity that the extra social care funding promised to provide.

The reality is that any extra funding will absorb some of the existing pressures. It would help to free up extra bed capacity in hospitals, pump much needed funds into community and mental health services, help to recruit more doctors, nurses and care home staff during this winter crisis.

It would also make better use of community pharmacy services and enable the ambulance service to take more of the patient load.

In the long term, we need to develop a realistic and sustainable long term approach to funding  the NHS and social care, and a comprehensive workforce strategy that takes account of what the NHS is being asked to deliver.

There is no time to lose. Last winter gave us the clearest possible warning that patient safety is now at risk. We have very short time to respond to those warnings. With the historical funding problems worsening in the last decade, a crisis in retention and recruitment, increasing demand, and collapse of social care in many places, I cannot be optimistic that the looming crisis can be averted by the measures announced.

It seems to me that we need an injection of extra resources, not just a vaccine against the flu virus.

Dr Kailash Chand OBE is the former deputy chair of the BMA council and honorary vice president of the BMA. Dr Chand writes in a personal capacity

Source: Independent