“Winter pressures”

This could well be the winter that breaks the NHS, or which has come the closest to it.

Every year, there are “winter pressures”, this refers to an expected uplift in work for NHS teams across the country, in particular front line services like Ambulance Services and A&E departments. However, this winter (and we’re not really even at the busiest bit yet), has been borderline ridiculous.

As an Ambulance Trust, we have REAP levels (think of them as Def-Con levels all the American films have). We usually bimble around at REAP 3, this is where everything is at its normal; many many calls, but just about enough resources to cover it, enough vehicles and enough staff.

REAP 4 is slightly more chaotic. The sheer volume of 999 calls puts serious pressure on everyone and there is a really struggle to find resources (by which I mean Ambulances) to answer the calls. Staff sickness/absence means that shifts are dropped as there are no medics to cover them.

We’ve spent a large majority at REAP 5. There are only 6 REAP levels, and at level 6, the trust is in melt down. At REAP 5, there are not enough ambulance, not enough medics, not enough call takes and not enough dispatchers to cope with the huge volume of calls we receive. Calls come in faster than we can triage them and the difficult decision is made not to respond to low priority green calls (such as non-emergency transport to a department, minor cuts to limbs or vomiting).

At this point, our trust was on the verge of declaring a Major Incident. I’m not wholly sure what happens at this point, but as a crew we can only do one emergency at a time, so there’ll probably be little change.

Let me give you some numbers. In our division, we normally receive around 1000 999 calls in a 24 hour period, lately, we’ve received over 1500 calls in the same period. There are no more Ambulance and probable less staff to answer those additional 500 cries for help. This is why we are REAP 5.

Hospitals have it just as bad. There are simply no beds for the patients that need to be admitted. At one point, I counted 17 patients on trolleys and in wheelchairs in the corridor of one A&E department, but let me say that. Every one of those patients was receiving excellent care. They were having medical obs’ done, Doctors were speaking with them, they were taken to a private room for examination. It was a joy to watch this level of organisation.

With all this in mind, I’m worried. January and February are typically our ‘busy’ months, and we’re almost at capacity now!!  Lord help us and all NHS Staff!

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