The early morning rain swept the tarmac. A bitter wind joined in, doing its best to make the January start to 2022 as miserable as possible.
The rain was pounding a deafening tattoo on the plastic roof of the tent.
The Red Cross were doing what they could.
Desperate times…
No, not the opening paragraph from my new novel…
... but a story of a wealthy country where the government was unable to make decisions. Their fragile healthcare system… all-but collapsed.
A humanitarian crisis in BoJo’s Britain.
If I’d told you, yer-granny, could be looked-after in a tent in a carpark, the Army would deliver her home, into the care of the Red Cross… you’d have laughed me off the page.
Well, it’s happening. Why?
The three L’s.
Legacy; ten years of post-banking-crisis, flat-line funding, leaving the NHS with fewer beds and staff than most comparable EU and OECD healthcare systems.
The NHS went into the COVID crisis unprepared, unrehearsed, under-resourced and survives on energy and unlimited good-will.
Leadership; as the Covid months have dragged on the economic damage, horrible. Slow decisions compounded problems.
A credibility-vacuum in leadership has divided the Tory Party.
Lunacy; a small group, led by Brexit-hard-man Steve Baker, who was instrumental in bringing down Theresa May, has engineered a situation where, unless Baker agrees, BoJo has no Commons majority.
The NHS is in free-fall… the pubs free to stay open.
Sensible public are imposing their own covid avoidance strategies.
With no customers, the businesses we have spent £billions saving, are now, with no support from HMG, withering on the vine.
Working from home has de-railed transport systems, now facing an avalanche of debt. Transport for London is probably, technically bankrupt. The number of sector-wide, passenger journeys reduced by 77.7%.
Revenues dropped by £8.6bn. Without massive subsidies, unsurvivable.
GDP declined by 9.7% in 2020, the steepest drop since consistent records began in 1948. Equaling the decline in 1921.
For every £100 this nation earns, £95 is now owed in debt.
And the NHS?
Hopes of reducing the 5.8m waiting list is gone.
In a normal year the NHS carries out 10m operations of which 2m are emergencies. It’s safe to assume there will be another 8m this year… and the next year and the year after…
Plus, the 5.8m (call it) 6m legacy waiters, that’s 14m.
Plus, an unidentified number who are yet to ‘present’ (as the NHS quaintly calls it), from last year and this. Pick a number? Call it 2m?
That gets us to 16m.
Plus, don't forget mental health, therapies, diagnostics, outpatients, aids-n-adaptations and social care. ?m, dunno.
As many as 66% might have been day-cases but as waits lengthen patients become more complex. That percentage will shrink.
Rule of thumb; for every consultant-led bed in the NHS in England there’s the equivalent of 40 people on the waiting list, now. If the number reaches 16m, call it about 113.
The current 5.8 million figure is about the same as every person in Denmark being on the NHS waiting list. Add-in Belgium and Slovenia to get to 16m.
Reach for the back of an envelope;
If half can be day-cases, we’ll have 8m admissions.
If, rough-average, theatre time, across all specialties, per-case, is (say) 4 hrs, that’s 32,000,000 theatre hours.
If lists are eight hours, that’s 4,000,000 days or (assuming 365 working?), 10,959 years of operating time.
Plus, pharmacy, therapies, imaging, primary care, social care.
Plus, 8m day cases…
Plus, 2m emergencies…
Hands-up... if I’m out by a half, with current staffing levels and bed capacity, the NHS will never catch-up and it’s stupid to pretend otherwise and who will do this mountain of work?
There’s no workforce plan. The NHS can do nothing until the DH+, the Treasury and No10 authorise one.
It's not Covid that's wrecked the NHS, it's Covid policy.
To stand a chance, six uncomfortable things;
Pick strategically placed Trusts to become regional trauma centres and the rest do walk-ins and become 24/7 elective factories.
Up-skill the workforce where possible. Conventional training will take way-too-long. Bring in auxiliary support, intensively trained in 18 weeks. Develop them on the job.
Reward Trusts for better people-retention strategies.
Create strategic partnerships with Trusts and the domiciliary care sector, for staffing recruitment and training. Fund Trusts to buy-them-out where possible.
NHSE Board, find your cojones. Tell BoJo, straight; the NHS cannot manage the future. Baker is ruining the workforce now, and wrecking the service for the next ten years…
… and number six?
Tell BoJo, visiting vaccination centres is not leadership. He needs to go figure out how to lead his Party.
>> I'm hearing - Nottingham University Hospitals Trust has enticed
Nick Carver out of retirement as interim CEO.
He will lead the recruitment process for a new substantive chief following Tracy Taylor’s resignation in October. She's been off sick with covid since July.
>> I'm hearing - staff shortages are now, so critical, some community staff are being redeployed across services and some community services, scaled back.
>> I'm hearing - There are no plans to redeploy student nurses back into the workforce. Don't know why?
>> I'm hearing - Shane Tickell has been voted vice-Chair of Tech-UK. Let's hope he can use his influence to demonstrate it's not just a club of old boys representing Big-Tech with lazy ideas.
>> I'm hearing - NHS trusts have been unable to get even close to the target for reducing delayed discharges set by NHS England, by a half. I honestly think the NHSE Board have, either, no idea what's going on, or they have taken leave of their collective senses.
At the end of Dec' there were on average 9,857 medically fit for discharge, just 836 fewer than the average of 10,693 in the week of 13th December.
>> I'm hearing - £walled Sunday Times report 'End of free lateral flow tests as country told to live with Covid'. This has been denied by HMG. If it is a lie, isn't there something called IPSO to complain to?
>> I'm hearing - Boots had a massive outage on their pharmacy web-site at the weekend?
