Covid has revealed shocking levels of NHS underfunding

By a Scottish NHS A&E doctor

During COVID-19 many things changed. Initially, there was a record low attendance at Emergency Departments and Acute receiving units across the board. This resulted from, among other things, a combination of people with illness’ avoiding coming to hospital and reduction in injuries as the public weren’t out driving, pubs were closed and sports weren’t taking place. This with the cancellation of most elective services and theatres meant that hospital staff were, for the most part, less busy initially. This didn’t last long when the hospital beds, including ICU began to fill up with COVID-19 patients.

During the second wave this was different. The attempt to keep elective services running throughout the wave, until the decision was forced to stop them, meant that there was a reduction in the number of staff available to run the COVID-19 wards. Furthermore, the staff who were there were tired and dreading the thought of another few months working long hours in PPE. This proved to be the larger and more challenging of the two waves.

There has been a constant presence of COVID-19 patients in wards and in intensive care throughout the summer months. It appears that the vaccine has help reduce the amount of patients requiring hospital admission and ITU admission, this is a massive achievement. However, there are still many thousands of patients admitted throughout the UK – as can be seen through the government stats.

Never in recent memory has such a large number of hospital and intensive care beds been taken up, so consistently, by a communicable disease. This proves a constant challenge for staffing, employee wellbeing, infection control and the continuing of elective and semi-elective services. On the ground, the number of staff missing shifts for covid tests, in many instances the result of their children missing school for the same reason, proposes a unique challenge to the already dire staffing situation. 

This summer there were record cases of childhood viral illnesses for the time of year. COVID-19 has reduced the ability of emergency departments to absorb excess patients by removing the option of corridor care; inadequate care perhaps, but better than the alternative, ambulances stacking at the doors of the Emergency Departments for many hours (with reports of patients coming to harm while waiting many hours for ambulances to arrive). 

This has overall reduced capacity of hospitals. This, coupled with the massive backlogs of elective theatre lists, has produced hospitals running at or near capacity for the majority of summer. This has resulted in cancellation of some already crammed elective lists. If this is summer, it doesn’t bode well for the coming winter.

Mental health services also need more funding. There was a fear that there would be a mental health crisis following the COVID-19 pandemic. However, this was the case before the pandemic with many patients waiting over a year for a referral to come through. Some of them presenting in crises to emergency departments in the meantime.

The COVID-19 pandemic has had other impacts. It appeared to re-invigorate the publics’ trust and belief in the NHS and socialised healthcare. It has transformed areas of medicine, such as telemedicine (distance medicine) to allow patients to have hospital appointments without travelling far distances (however it remains to be seen if this is being used efficiently and safely). It has also widened the access to medical conferences by having the majority hosted online as well as in person.

Whatever the changes, COVID-19 is here to stay.

What the NHS needs is the UK and Scottish governments to end years of underfunding and start investing in the NHS fully. This includes; staff shortages to be addressed as the root problem by increasing the number of healthcare professions such as nursing, dentistry, radiography, physio, occupational therapy, medicine coming through UK universities, and NHS support and ancillary staff generally. 

It needs to pay NHS workers fairly, the idea of NHS nurses using foodbanks should enrage anyone who believes in a fair society, which is why the NHS workers needs a 15% pay rise now (this is to combat against the real wage cuts they have suffered for 10 years). 

The NHS needs properly funded, to develop its own services and resources and reduce the amount of outsourcing to the private sector, which will always result in a larger loss over time. 

Social care needs nationalised and properly funded, our ageing population is an issue that is not going away and social care will only come more important in the future. Social care staff must have nationally agreed pay – not less than £15 an hour – and trade union negotiated terms and conditions