Matt Hancock announces more funds for A & E  

How could coronavirus affect Matt Hancock's career? | The Independent | IndependentConsidering how many cancers are picked up in A & E, it was good news when Hapless Hancock announced to the House of Commons that money is going to be made available to upgrade A & E departments.  Only a few – so don’t all jump at once!

How much exactly – no-one was available at the Dept. Health to answer that question (what a surprise).  But there is going to be something with which to paper over the cracks. And boy, does the average A & E need this.

I have the dubious distinction of visiting two A & Es in two separate countries in one day.  I’d landed in a holly bush (as one does riding a bicycle) and was rushed to A & E in Klagenfurt, an Austrian town of 100,000 people.  Seen immediately (for free) by doctor and nurse in a chrome-walled cubicle (obviously easy to scrub down) with elbow pressure pads instead of door handles, my whole one-hour experience was a text-book case of good care.

The Austrian nurse used tongs to open up a sterile pack of covers to drape over me, and all instruments came in sterile packs – opened for me and then sent off to be disinfected.  As I left to go out, I was about to push open the door, when the nurse stepped in front of me and showed me how I should use my elbow, not my hand.

Flying home that afternoon, one rogue holly prickle worked its way to the surface, so I went straight to my local A & E.  I waited a long time, was seen by a doctor wearing dirty scrubs, in a cubicle surrounded by curtains which everyone touched as they came in and out.  He used tweezers lying in a dish to dig out the prickle, and we had a good chat about how it was no wonder we picked up hospital infections.

Perhaps some of the extra dosh for A & E might go to installing elbow pressure pads instead of handles and switches, and provide equipment in sterile packs?

Waiting rooms

Thinking about the average hospital waiting room, one could argue that only basic equipment is provided because patients aren’t supposed to spend much time there.  But – compared with A & E in hospitals abroad, what is there is often very basic. Wire-rack metal seating that can be wiped clean easily might be a good idea, until one has to sit on these seats for four hours or more, often in pain.  Glaring neon lighting can give you a headache, and water coolers always seem to have run out of cups. As for the curtains around beds – hasn’t anyone seen the way A & E is fitted out in many European hospitals.

Incidentally, the last time I came into my local A & E by ambulance, I was put on a trolley waiting in a corridor.  I could see all the cubicles, closed in by curtains, and waited to be moved.  But I stayed in the corridor for all the eight hours I was there – and then realised it is easier and quicker to clean down a trolley than it is to wipe down a cubicle between each patient.  I am happy with that. 

Drunks

It would be lovely not to have to listen to the verbal abuse shouted at hospital staff during late-night A & E visits, nor have to witness staff attending to drunks instead of looking after me.  So take a leaf out of Continental hospitals’ books;  swipe the drunk’s credit card for a minimum of the £400 on average it takes to deal with them, then lock them in a room to sober up.  If they can spend a vast amount getting drunk, they can afford the consequences.  Why should my limited NI contribution have to cover their care? Go over to Paris or Hamburg and see how it’s done there.

Where’s are the funds coming from?

Matt Hancock announced in Parliament:

  • We will make our emergency departments bigger. Many are simply too small. (This was true even before the pandemic, but it’s even more acute now).
  • We are investing to expand capacity in urgent and emergency care so hospitals have the space to continue treating patients safely in the coming months.

In August, he confirmed £300 million for emergency upgrades across 117 Trusts. This week he went further and announced £150 million to expand 25 more emergency departments – including some of the most constrained in the country like Worcester and the Royal Shrewsbury.

So does that add up to £450 million?  Or is he extra £150 million coming out of the original £300 million?  (I have a suspicious mind).

Hancock expected “this extra funding will put us in the strongest possible position for this winter, and boost the crucial work to accelerate non-Covid care”.  Then went on to say

” it’s not just about the space, but about the service. So we are working to get patients the right care in the right place, by expanding the role of NHS 111.

During the peak of this pandemic, we saw millions of people using NHS 111, on the phone or online, to get the best possible advice on coronavirus. Helping them to stay safe, and where possible stay out of hospital, where they could have unknowingly spread the virus. It is crucial that ahead of winter, we use this window of opportunity to seek out what worked and build on it, so we provide a better service for patients and protect the NHS.

Of course no-one will ever be turned away from our emergency departments in the most serious of cases.

However, we have worked with the Royal Colleges, with the NHS and others to develop a better, quicker and more Matt \clinically appropriate service for patients, by using NHS 111 First.

We will invest £24 million to increase call handling capacity and to make sure there are more clinicians on hand to provide expert advice and guidance”.  N.B. Perhaps at the same time they might address the often inappropriate and time-consuming on-screen questions the 111 call handler has to ask?

“So in future, rather than having to queue in an emergency ward, we are testing that people should call NHS 111 First to book an appointment with whoever can give them the most appropriate care”

Somehow, I am not sure how Dad, who has fallen off a ladder and hurt his back, is going to react to a 111 operator asking “do you have a temperature, etc”, when Dad knows he needs an X-ray – and fast.

Let’s hope the funds are made available urgently, to provide much-needed upgrades to some of our creaking A & E departments. 

 

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