A patient going into ‘cardiac arrest in the waiting room’, ‘people dying outside the resuscitation area because there’s no room inside’, and ‘patients dying while waiting for ambulances’.
Emergency medics are describing scenes of horror for patients and their families in A&Es across Greater Manchester and the wider north. Speaking on condition of anonymity, emergency department doctors and a paramedic told the Manchester Evening News harrowing stories from inside the NHS, happening ‘on a daily basis’.
The increasingly dark days come as the president of the Royal College of Emergency Medicine, Dr Adrian Boyle, has said as many as 500 people could be dying each week because of delays to emergency care. A crippled social care system and a wave of flu and Covid are adding yet more pressure to hospitals which are bursting at the seams with patients.
READ MORE: In tears as the NHS crumbles
'By the time we get there, they're already dead...It's like a warzone'
Medics from inside hospitals and out are telling the same story: emergency departments and emergency services alike are on their knees - with devastating consequences for patients and their loved ones.
“We are witnessing harm on a daily basis with patients either dying in the emergency department or their condition significantly worsening before they have been seen and/or admitted,” one Greater Manchester A&E consultant said.
A junior doctor from a different hospital in the region agreed that patients were ‘100 per cent’ dying as a result of unprecedented delays to care in A&Es.
“We’re right on the knife’s edge. People are dying,” explained a paramedic from North West Ambulance Service working in Greater Manchester.
“We’re reaching them 12 hours later than we should. Had we got there earlier, they would have been alive - by the time we get there, they are already dead.
“If they are alive when we get to them, they’re dying in the ambulance after waiting 12 hours for us, or they're dying as they wait eight hours in A&E.
"They’re dying going through the doors of A&E, dying while we wait with them on corridors, dying because there’s no room in resus so they go into cardiac arrest outside it [the resuscitation area where the people with potentially life-threatening conditions will be taken when they arrive at hospital].
“It’s like a warzone.”
A terrifying picture reflected across the north
Medics from across the country are reporting similar, harrowing scenes. A doctor elsewhere in the north told the Manchester Evening News of record emergency departments attendances, while ambulances have waited 'nine hours before they could offload a patient', before multiple patients go on to wait '48 hours' in A&E.
"We had a patient have a cardiac arrest in the waiting room," the medic said. "We ran out of hospital beds so there were elderly frail patients who already had pressure sores on trolleys for days. [There are] trolleys lining the corridors.
"Resus is wild and not safe, patients who should be in resus are just in trolleys at triage."
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“[Seeing the highest ever numbers of attendances in emergency departments] is almost a universal issue. It can only go one way in terms of numbers when there's inadequate social care support and wards are completely full… I don't know any A&E department that isn't several times over capacity for patients and understaffed,” concurred the Greater Manchester junior doctor.
“This is a national picture. You get short term respite some days but it never lasts."
Staff ‘ending shifts in tears’ and ‘casually expressing suicidal intent’
As staff witness patients deteriorate as hospitals come to breaking point, they fear the harm being caused on their watch - despite their best efforts.
“Apart from the unacceptable risk to patient safety, it is also causing massive harm to staff who are trying to do their best with inadequate resources but who are unable to give the quality of care the patients deserve and which we have been trained to do.
"Many end the shift in tears and are unable to sleep or rest on their days off because of worrying about what harm may have come to patients that they have been responsible for,” explained the Greater Manchester A&E consultant.
“It's a daily occurrence that colleagues —grown doctors doing their absolute best in impossible conditions—are crying and having to take sick leave for burnout and PTSD,” agreed a junior doctor in a different Greater Manchester hospital.
Looking around the north, an A&E doctor speaks of ‘traumatised and crying staff’ who ‘casually express suicidal intent’, amid an exodus of staff leaving the service.
"Several of my quite young colleagues have casually expressed suicidal intent to me recently and I worry about them and message them constantly,” the doctor told the M.E.N. “Some are also very worried about getting training posts and losing their visas if they don't."
Another North West Ambulance Service worker has warned that “morale is rock bottom” in the service, saying he knows of at least three colleagues who have taken their own lives in the last year. Multiple paramedics and ambulance service workers have shared their desperation at being stuck outside hospitals, unable to hand patients into the care of doctors because there is no capacity inside.
Sarb Bajwa, chief executive of the British Psychological Society, said earlier this month: “There is no magic solution to the issues faced by the health service, and it is highly unlikely that meaningful change will happen quickly enough to alleviate the unmanageable pressure on NHS staff working desperately hard to prop up under-resourced services. For too many health and care professionals, it is at the detriment of their own health and wellbeing.”
"We acknowledge the pressure across the system"
A spokesperson for the NHS in the North West, responding to the claims of Greater Manchester staff, said: “The NHS, across the country, is going through a period of exceptional pressure, with demand for services at exceptional levels, the North West Region is no different and has seen staff in all services across the system responding to patients' needs.
“This is particularly evident for the ambulance service, NHS 111 (which received record call numbers over the Christmas and New Year period), in our A&E departments and in General Practice. These pressures are also seen in our community services, mental health services and for cancer referrals.”
“We are profoundly grateful to the efforts of all NHS and care staff across the North West, who have already gone above and beyond the call of duty to ensure our patients receive the highest standards of care possible throughout this difficult time.
“Staff across our hospitals, community services, the ambulance service, primary care and allied health professionals are doing all they can to meet people’s needs and their commitment, dedication and hard work continues to be a point of pride for each and every one of us.
“We would urge the public to ensure they are doing everything they can to contribute to that effort and would urge those who are eligible to come forward for flu and COVID-19 vaccines as soon as possible.
“The public can also help us manage the high demand we are seeing by ensuring you are seeking help from the most appropriate health services, using NHS 111 online for 24/7 advice about the most appropriate care for your needs, and only attending A&E if seriously ill or injured. This will help us keep those services free for those that need them the most.”
“We acknowledge the pressure across the health and care system and recognise the immense impact on staff," added a Greater Manchester NHS spokesperson. We appreciate the efforts staff have gone to throughout a period of sustained pressure and remain committed to supporting our workforce.
“NHS Greater Manchester has a number of wellbeing programmes in place and we’re working with partners to try and address some of the issues raised. Our focus is on making sure patients are safe and that critical services can keep running. All partners in the NHS, social care and voluntary sector are working together to support hospital admissions, where needed, and timely discharges for those who are medically fit to go home.”
Responding to the words of the doctor from another area of the north, a spokesperson for the NHS in the North East and Yorkshire referred the M.E.N to a comment made on January 12 by NHS National Medical Director, Professor Sir Stephen Powis, who said: “As staff responded to record A&E attendances, 999 calls and emergency ambulance call outs as the ‘twindemic’ lead to unprecedented levels of respiratory illness in hospital, they also continued to deliver for patients with more people than ever before receiving diagnostic tests and cancer treatment.
“These figures show just how hard our staff are working, not only in the face of extreme pressure but also in bringing down the Covid backlogs and checking more people for cancer than ever before in one month.
“The NHS will keep its foot on the accelerator to continue to make progress on the Covid backlog and hospitals have today been asked to ensure anyone waiting longer than 18 months has their treatment booked in before March."
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