At 7am yesterday morning, Croydon University Hospital (CUH) declared an ‘internal major incident’ in the light of the pressure its Accident & Emergency Department was under. This is one level down from the ‘major external incident’ that a number of hospitals around the country have declared and they announced the incident was over yesterday afternoon. Nevertheless, the fact that our hospital had to take this step is clearly a cause for concern. Why is our Accident & Emergency Department under such pressure and what can be done about it?
Accident & Emergency Departments across the country are under pressure because they are having to treat more patients. As this guide to the problem shows, over a million more people visited A&E departments last year than in 2010. And with our population ageing and many elderly people living with chronic health conditions, an increasing proportion of those who go to an A&E Department require admission to hospital, particularly at this time of year. Furthermore once their condition has been stabilised and they no longer require a bed in an acute hospital, it can take too long to put the necessary arrangements in place to discharge such patients to a residential home or community hospital or arrange care to enable them to return home.
Why is our hospital one of those that is particularly struggling? Partly because under governments of both colours the NHS in Croydon has never received its fair share of the national budget and partly because the Accident & Emergency Department at Croydon University Hospital was built in the 1980s to treat about 70,000 patients a year but is currently treating around 120,000 patients a year. Every day, about 100 ambulances arrive at the department - more than at any other in south-west London.
So what can be done to ensure that the NHS as a whole and our hospital in particular can cope with the pressures it is facing?
First, government needs to make sure the NHS has the necessary funding. Over the last four years, we have increased the NHS budget each year, protecting it from the cuts we have had to make in other areas. As a result, the NHS has more doctors and nurses than it did in 2010, including almost 1,200 more A&E doctors. But with our population growing, people living longer (often with chronic conditions) and pioneering (but expensive) new treatments becoming available every year, this extra funding has barely enabled the NHS to keep pace with growing demand. In November, the Chancellor therefore announced a further £2 billion for the NHS every year. He was only able to find this money because our economy is doing well and we have made tough decisions elsewhere.
Second, hospitals, other parts of the NHS and social care need extra funding each winter to help them cope with the additional pressures they face. This year, we have provided a record extra £700 million. The first tranche of this money was made available earlier than ever and it pays for the equivalent of 1,000 extra doctors, 2,000 nurses and 2,000 community staff, including social workers and physiotherapists.
Third, we need to ensure that when people are ready to leave hospital they are quickly discharged to an appropriate setting.
Fourth, people should only go to A&E or call 999 if they have a genuine emergency. If you are feeling unwell, you should call NHS 111 or contact your local GP for advice.
Fifth, we need to make sure the NHS in Croydon is fairly funded. The Government has just taken a big step in the right direction in this regard, changing the way it allocates the NHS budget around the country so that Croydon gets a fairer deal. As a result, our local NHS will be getting a big above-inflation increase in April - much bigger than most parts of the country.
And sixth, we need a new Accident & Emergency Department at CUH. This is something I have been working hard on behind the scenes and I am hopeful of some good news later this year.
A brief political point: Labour are seeking to say this is all the Government’s fault and nothing to do with our rising and increasingly elderly population. The fatal flaw in that argument is that A&E Departments in England are performing significantly better than their counterparts in Wales where Labour are in charge (and indeed their counterparts in Northern Ireland and Scotland).
Finally a huge thank you to the staff at Croydon University Hospital A&E Department for the dedicated care they continue to provide to my constituents despite the pressure they are under.
UPDATE: I am pleased to report that in the last night fortnight the number of patients being seen within four hours has significantly improved from 80% in the week ending 4/1 to 94% in the week ending 18/1. This is an amazing achievement by the hospital's staff.