1. People are more unwell than ever before
While Britain’s healthy life expectancy – the time people live free of disease or disability – is lengthening, there has also never been more illness. Obesity, drinking and smoking are producing an ever-larger toll of lifestyle-related diseases such as cancer, diabetes and drink-related liver damage.
2. The population is ageing
More older people mean more broken bones, more dementia, more infections, more failing hearts and lungs and much else besides. That trend will only continue. And the problem is compounded in the depths of winter, with colds and vomiting outbreaks common – though no significant outbreak has yet hit this winter.
3. People suffering from mental health problems are also adding to the pressures on A&E units because support is not available in the community
Though the statistics aren’t measured any more it’s estimated the number of people with mental health problems arriving at A&Es is increasing.
4. The 111 emergency helpline is sending too many people to A&E
There are suggestions that the new non-emergency line, introduced last year, is sending too many people to hospital. The Times reports that 7% of callers are told to attend A&E and in one in 10 cases they are sent an ambulance. Call handlers follow a script and, according to Suzanne Mason, professor of emergency medicine at Sheffield University: “There are certain times of day and days of the week when call handlers get to the bottom of the algorithm and look at what services are available locally and there isn’t anything there.”
5. Too few GPs mean it’s hard to get an appointment
There is a recruitment crisis in the NHS. Older GPs are retiring early to avoid burnout and too few newly qualified doctors are opting to join general practice. The result is long waits for appointments – meaning patients increasingly use A&E as their first, rather than last, port of call. More hospitals are pleading with patients to seek help elsewhere for less serious problems, but to no avail.
6. Young people are bypassing GPs to take their health problems straight to A&E
Lifestyles are changing and the NHS isn’t catching up. A report by Citizens Advice found people aged 18 to 34 are more than twice as likely to visit A&E departments or walk-in centres than those aged 55 and over. It suggests that younger working people are finding it harder to wrestle GP appointments into their schedules and instead ending up in A&E.
7. Cuts to social care are making it harder to discharge even healthy people once a hospital has mended them Heavy cuts to social care services have followed austerity’s deep cuts to local council budgets. Older and frail people who end up in hospital become harder to discharge without social care to look after them at home, causing bed blockages that have knock-on effects for A&Es who then can’t discharge people to full wards.
